Stanley David Smith, ATC, CSCS
Individual provider Active NPI Athletic Trainer · S Williamsport, PA
NPI 1164551073 · NPPES record last updated Aug 14, 2007
Key facts
- NPI
- 1164551073
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- RT001043A (PA)
- Practice address
- 700 Percy St
S Williamsport, PA 17702-7522 - Phone
- (570) 326-2684
- Fax
- (570) 326-2687
- NPI assigned
- Mar 5, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RT001043A | PA | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | RT001043A | PA | Yes |
Addresses
Primary practice location
700 Percy St
S Williamsport, PA 17702-7522
Mailing address
1959 W Southern Ave
Williamsport, PA 17702-6944
Phone (570) 320-0129
Other providers in S Williamsport, PA
- Kristopher Doersam
- Garner Behavior Services LLC
- Danielle Stefani Palm
- Pennsylvania CVS Pharmacy, L.L.C.
- Lori Ann Rinker
All providers in S Williamsport, PA · Athletic Trainer in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.