Individual
BRETT R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1040 GULF BREEZE PKWY, SUITE 200, GULF BREEZE, FL 32561-7809
(850) 916-3700
(850) 916-3710
Mailing address
PO BOX 30532, PENSACOLA, FL 32503-1532
(850) 916-3700
(850) 916-3710
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
30241
AZ
207X00000X
Orthopaedic Surgery Physician
MD073529L
PA
207X00000X
Orthopaedic Surgery Physician
Primary
ME105667
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001853100
—
FL
05
—
1017642910001
—
PA
05
—
114534
—
AL
05
—
115066
—
AL
01
—
146QJ
BLUE CROSS BLUE SHIELD
FL
05
—
2698586
—
OH
05
—
3810008259
—
WV
01
—
592-09123
BLUE CROSS BLUE SHIELD
AL
01
—
592-09139
BLUE CROSS BLUE SHIELD
AL
01
—
7998568
AETNA
—
05
—
881244
—
AZ
01
—
P00807016
MEDICARE RAILROAD
—
Enumeration date
01/20/2006
Last updated
11/29/2011
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