Most Relevant Information
Provider Data
| NPI Number: | 1003275009 |
| Provider Name: | WILLIAM SMITH |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: | 10-09-50 |
Most Important Dates
| Enumeration Date: | 02/18/2016 |
| Last Updated: | 02/18/2016 |
Provider Practice Location
761 SW DARCY AVE
SILETZ
OR
973802019
Practice Location Phone/Fax
| Phone: | 5415749570 |
| Fax: | 5415748857 |
Provider Mailing Location
761 SW DARCY AVE
SILETZ
OR
973802019
Provider Mailing Phone/Fax
| Phone: | 5415749570 |
| Fax: | 5415748857 |