Provider Demographics
NPI:1689613242
Name:SMITH, JOAN D (MD)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:D
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:789 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2526
Mailing Address - Country:US
Mailing Address - Phone:603-664-2135
Mailing Address - Fax:603-664-9128
Practice Address - Street 1:8 CENTURY PINES DR
Practice Address - Street 2:SUITE 2
Practice Address - City:BARRINGTON
Practice Address - State:NH
Practice Address - Zip Code:03825-3732
Practice Address - Country:US
Practice Address - Phone:603-664-2135
Practice Address - Fax:603-664-9128
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2014-02-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH11229207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3075376Medicaid
ME1689613242Medicaid
ME1689613242Medicaid
NHG84338Medicare UPIN