Edward W.P. Smith, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME0026592 Issued in FL

Practice address

4479 Baymeadows Rd
Jacksonville, FL 32217-4716

Phone

(904) 731-8300

Fax

(904) 737-7901

NPI assigned

Jan 27, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1467423533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4479 BAYMEADOWS RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174716",
            "telephone_number": "904-731-8300",
            "fax_number": "904-737-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4479 BAYMEADOWS RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174716",
            "telephone_number": "904-731-8300",
            "fax_number": "904-737-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EDWARD",
        "middle_name": "W.P.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME0026592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Smith, COTA
• Donna Dorman Smith, CRNA
• Donna Jo Smith, PA-C
• Doris Elizabeth Smith, ARNP
• Duncan Kenneth Smith, O.D.
• Emily Nicole Smith
• Erica Self Smith, APRN
• Erin Theresa Smith
• Frances Smith, PT
• Fredrica Monea Smith, LMT

• Dermatology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.