Provider Demographics
NPI:1356442933
Name:SMITH, SCOTT G (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:G
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10470 OLD PLACERVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:2725 CAPITOL AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-6004
Practice Address - Country:US
Practice Address - Phone:916-262-9440
Practice Address - Fax:916-262-9445
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2015-07-22
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Provider Licenses
StateLicense IDTaxonomies
CAG81466207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G814660Medicaid
00G814660Medicare ID - Type Unspecified
CA00G814660Medicaid