Provider Demographics
NPI:1285682393
Name:NESMITH, RICHARD L (MD DMD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:L
Last Name:NESMITH
Suffix:
Gender:M
Credentials:MD DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 NW 9TH BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4269
Mailing Address - Country:US
Mailing Address - Phone:352-331-3401
Mailing Address - Fax:352-332-0922
Practice Address - Street 1:6801 NW 9TH BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4269
Practice Address - Country:US
Practice Address - Phone:352-331-3401
Practice Address - Fax:352-332-0922
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0057328208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10215Medicare ID - Type Unspecified
FLC82118Medicare UPIN