Provider Demographics
NPI:1376630681
Name:SMITH, JAMES A III (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:SMITH
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:1502 W NC HIGHWAY 54
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-5571
Mailing Address - Country:US
Mailing Address - Phone:919-403-2122
Mailing Address - Fax:919-401-4993
Practice Address - Street 1:1055 DRESSER CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7323
Practice Address - Country:US
Practice Address - Phone:919-876-3130
Practice Address - Fax:919-876-3134
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC248142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8977661Medicaid
2024734AMedicare ID - Type Unspecified
H46789Medicare UPIN