Provider Demographics
NPI:1811460744
Name:THOMAS V SMALLMAN, MD, PLLC
Entity type:Organization
Organization Name:THOMAS V SMALLMAN, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:V
Authorized Official - Last Name:SMALLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-415-0612
Mailing Address - Street 1:3 CHESTNUT CIR
Mailing Address - Street 2:
Mailing Address - City:SKANEATELES
Mailing Address - State:NY
Mailing Address - Zip Code:13152-1301
Mailing Address - Country:US
Mailing Address - Phone:315-415-0612
Mailing Address - Fax:315-554-8185
Practice Address - Street 1:5100 W TAFT RD STE 2R
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-4841
Practice Address - Country:US
Practice Address - Phone:315-457-4400
Practice Address - Fax:315-457-3400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty