Smith, Derek R
Smith, Derek R is an individual health care provider with primary practice located at One Towne Park Plaza , Norwich CT 06360. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Smith, Derek R can be contacted via phone (860) 886-1433.Contact Information
Primary practice address
One Towne Park Plaza
Norwich CT 06360
Phone: (860) 886-1433
Fax: (860) 886-4644
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 43390 | Connecticut |
Profile Details
| NPI number | 1407869019 |
|---|---|
| LBN Legal business name | Smith, Derek R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 14th, 2006 |
| Last updated | Jul 19th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407869019 | NPPES |
| Connecticut | MEDICAID | 001433903 |
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