Provider Demographics
NPI:1881981298
Name:SMITH, DOUGLAS ANTHONY (DO)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:ANTHONY
Last Name:SMITH
Suffix:
Gender:M
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:24 HOSPITAL AVE
Mailing Address - Street 2:DANBURY HOSPITAL EMERGENCY DEPARTMENT
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6099
Mailing Address - Country:US
Mailing Address - Phone:203-739-7447
Mailing Address - Fax:203-739-8049
Practice Address - Street 1:24 HOSPITAL AVE
Practice Address - Street 2:DANBURY HOSPITAL EMERGENCY DEPARTMENT
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6099
Practice Address - Country:US
Practice Address - Phone:203-739-7447
Practice Address - Fax:203-739-8049
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOT014177390200000X
CT53805207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program