Provider Demographics
NPI:1215955844
Name:SMITH, THOMAS W (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:W
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4860 Y ST STE 2820
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2307
Mailing Address - Country:US
Mailing Address - Phone:916-734-3672
Mailing Address - Fax:
Practice Address - Street 1:4860 Y ST
Practice Address - Street 2:SUITE 2820
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-734-3672
Practice Address - Fax:916-734-8394
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2020-05-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA86610207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine