Provider Demographics
NPI:1285197244
Name:SMITH, CARSON JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:CARSON
Middle Name:JAMES
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4860 Y ST STE 3800
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:916-734-2807
Mailing Address - Fax:916-734-7904
Practice Address - Street 1:4860 Y ST STE 3800
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-734-2807
Practice Address - Fax:916-734-7904
Is Sole Proprietor?:No
Enumeration Date:2019-04-08
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA191687207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery