Provider Demographics
NPI:1558662262
Name:CINDY A P SMITH MD PC
Entity Type:Organization
Organization Name:CINDY A P SMITH MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-404-3376
Mailing Address - Street 1:13605 XAVIER LN
Mailing Address - Street 2:B
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-3603
Mailing Address - Country:US
Mailing Address - Phone:303-404-3376
Mailing Address - Fax:303-468-8793
Practice Address - Street 1:13605 XAVIER LN
Practice Address - Street 2:B
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-3603
Practice Address - Country:US
Practice Address - Phone:303-404-3376
Practice Address - Fax:303-468-8793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-11
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31308207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODR-31308OtherSTATE LICENSE