Provider Demographics
NPI:1043410905
Name:DRS POULTON & SMITH LLC
Entity Type:Organization
Organization Name:DRS POULTON & SMITH LLC
Other - Org Name:DRS.POULTON & ACRI LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:K
Authorized Official - Last Name:POULTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-686-7876
Mailing Address - Street 1:5233 KING AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4001
Mailing Address - Country:US
Mailing Address - Phone:410-574-3100
Mailing Address - Fax:410-574-3710
Practice Address - Street 1:5233 KING AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4001
Practice Address - Country:US
Practice Address - Phone:410-574-3100
Practice Address - Fax:410-574-3710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty