Individual
DR. MARK DOUGLAS SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7100 OAKMONT BLVD. STE 108, FORT WORTH, TX 76132
(817) 370-2657
(817) 370-2186
Mailing address
7100 OAKMONT BLVD. STE 108, FORT WORTH, TX 76132
(817) 370-2657
(817) 370-2186
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
H5975
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0986929-02
—
TX
Enumeration date
07/24/2006
Last updated
08/30/2010
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