Provider Demographics
NPI:1548405640
Name:SMITH, SAMUEL W JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:W
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:725 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4109
Mailing Address - Country:US
Mailing Address - Phone:413-447-2752
Mailing Address - Fax:413-496-6836
Practice Address - Street 1:777 NORTH ST
Practice Address - Street 2:BFS NEUROSURGERY AT BHS
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4147
Practice Address - Country:US
Practice Address - Phone:413-447-2870
Practice Address - Fax:413-447-2871
Is Sole Proprietor?:No
Enumeration Date:2008-12-04
Last Update Date:2010-02-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA974363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical