Provider Demographics
NPI:1023206968
Name:SMITH, IRVING S (DO)
Entity Type:Individual
Prefix:
First Name:IRVING
Middle Name:S
Last Name:SMITH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 ST JOHNSBURY ROAD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561
Mailing Address - Country:US
Mailing Address - Phone:860-364-7029
Mailing Address - Fax:860-364-7079
Practice Address - Street 1:580 ST JOHNSBURY ROAD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561
Practice Address - Country:US
Practice Address - Phone:860-364-7029
Practice Address - Fax:860-364-7079
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT048601207RS0012X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine