Provider Demographics
NPI:1407806466
Name:SMITH, VICTORIA T (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:T
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 360001
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89036-8108
Mailing Address - Country:US
Mailing Address - Phone:702-636-3000
Mailing Address - Fax:702-636-3027
Practice Address - Street 1:3131 LA CANADA ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2578
Practice Address - Country:US
Practice Address - Phone:702-636-3000
Practice Address - Fax:702-636-3027
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD014592E2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine