Provider Demographics
NPI:1023127180
Name:SMITH, MARCIA BARRETT (MD)
Entity type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:BARRETT
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARCIA
Other - Middle Name:
Other - Last Name:BOURAIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:715 N HOPE AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1576
Mailing Address - Country:US
Mailing Address - Phone:805-687-3396
Mailing Address - Fax:
Practice Address - Street 1:715 N HOPE AVE
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1576
Practice Address - Country:US
Practice Address - Phone:805-687-3396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG44437207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC22027Medicare UPIN
CAG44437Medicare ID - Type Unspecified