Provider Demographics
NPI:1982779526
Name:SMITH, LANE FIELDING (MD)
Entity Type:Individual
Prefix:DR
First Name:LANE
Middle Name:FIELDING
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8871 W SAHARA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5865
Mailing Address - Country:US
Mailing Address - Phone:702-838-2455
Mailing Address - Fax:702-838-7055
Practice Address - Street 1:8871 W SAHARA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-5865
Practice Address - Country:US
Practice Address - Phone:702-838-2455
Practice Address - Fax:702-838-7055
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT274582-1205208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT880512075OtherTAX ID #
UT880512075OtherTAX ID #
UTE29327Medicare UPIN