Provider Demographics
NPI:1528220837
Name:EARL C. SMITH, M.D. P.A.
Entity Type:Organization
Organization Name:EARL C. SMITH, M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EARL
Authorized Official - Middle Name:C
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-376-5511
Mailing Address - Street 1:320 S POLK ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79101-1426
Mailing Address - Country:US
Mailing Address - Phone:806-376-5511
Mailing Address - Fax:806-376-8953
Practice Address - Street 1:320 S POLK ST
Practice Address - Street 2:SUITE 300
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79101-1426
Practice Address - Country:US
Practice Address - Phone:806-376-5511
Practice Address - Fax:806-376-8953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD7306207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00P767OtherBCBS
TX089587201Medicaid
TXD69104Medicare UPIN