Provider Demographics
NPI:1972660520
Name:ERIC S SMITH MD INC
Entity Type:Organization
Organization Name:ERIC S SMITH MD INC
Other - Org Name:WHATCOM OCCUPATIONAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:S
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-676-1693
Mailing Address - Street 1:3010 SQUALICUM PARKWAY
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225
Mailing Address - Country:US
Mailing Address - Phone:360-676-1693
Mailing Address - Fax:360-676-5458
Practice Address - Street 1:3010 SQUALICUM PARKWAY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225
Practice Address - Country:US
Practice Address - Phone:360-676-1693
Practice Address - Fax:360-676-5458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602514846261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2035444OtherGROPU LTI