Provider Demographics
NPI:1831226935
Name:SMITH, DOUGLAS WAYNE (DC)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:WAYNE
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 S LA CUMBRE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-6130
Mailing Address - Country:US
Mailing Address - Phone:805-964-0333
Mailing Address - Fax:805-964-0552
Practice Address - Street 1:38 S LA CUMBRE RD STE 2
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-6130
Practice Address - Country:US
Practice Address - Phone:805-964-0333
Practice Address - Fax:805-964-0552
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 17824111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC 17824Medicare ID - Type UnspecifiedDOUGLAS W SMITH DC