Provider Demographics
NPI:1740397017
Name:SMITH, RICHARD HUNT (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:HUNT
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11750 W 2ND PL
Mailing Address - Street 2:MEDICAL PLAZA 1, SUITE 255
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1575
Mailing Address - Country:US
Mailing Address - Phone:720-321-8040
Mailing Address - Fax:
Practice Address - Street 1:11750 W 2ND PL
Practice Address - Street 2:MEDICAL PLAZA 1, SUITE 255
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1575
Practice Address - Country:US
Practice Address - Phone:720-321-8040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-463702084N0400X
CO233442084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01233444Medicaid
COCL6028Medicare PIN
CO01233444Medicaid