Provider Demographics
NPI:1407837974
Name:SMITH, ROGER STUART (DO)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:STUART
Last Name:SMITH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100225
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0225
Mailing Address - Country:US
Mailing Address - Phone:352-273-8737
Mailing Address - Fax:352-273-9154
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0225
Practice Address - Country:US
Practice Address - Phone:352-273-8737
Practice Address - Fax:352-273-9154
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9071932-89042084S0012X
FLOS22797207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ28437OtherBCBS OF MA
MAA37447Medicare PIN
MAJ28437OtherBCBS OF MA