Individual
DR. WILLIAM J. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC., CCST
Contact information
Practice address
1400 S AVE D, PORTALES, NM 88130-6886
(505) 356-4440
(505) 356-4433
Mailing address
1400 S AVE D, PORTALES, NM 88130-6886
(575) 356-4440
(575) 356-4433
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
NM1130
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201009423
PRESBYTERIAN PROVIDER #
NM
01
—
350023553
RAILROAD MEDICARE PIN
NM
05
—
K9129
—
NM
01
—
NM01K995
BCBS PROVIDER #
NM
Enumeration date
01/04/2006
Last updated
07/14/2008
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