Provider Demographics
NPI:1437167319
Name:SMITH, ERIC LAURENCE (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:LAURENCE
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 NOBLE ST
Mailing Address - Street 2:PO BOX 587
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-9300
Mailing Address - Country:US
Mailing Address - Phone:919-989-9559
Mailing Address - Fax:919-989-5992
Practice Address - Street 1:7 NOBLE ST
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-9300
Practice Address - Country:US
Practice Address - Phone:919-989-9559
Practice Address - Fax:919-989-5992
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2455111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890832UMedicaid
NCU71850Medicare UPIN
NC2452267AMedicare PIN