Individual
DR. ELLISON LEON SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4 VANDERBILT PARK DR, SUITE 200, ASHEVILLE, NC 28803-1700
(828) 258-9533
(828) 253-4434
Mailing address
4 VANDERBILT PARK DR, SUITE 200, ASHEVILLE, NC 28803-1700
(828) 258-9533
(828) 253-4434
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
9900353
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194N
BLUE CROSS
NC
01
—
1780647578
GROUP NPI
NC
01
—
2263571
MEDICARE PROVIDER NUMBER
NC
05
—
891194N
—
NC
Enumeration date
04/13/2006
Last updated
05/28/2013
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