Provider Demographics
NPI:1366428187
Name:SMITH, CURTIS JAMES (PA-C)
Entity type:Individual
Prefix:
First Name:CURTIS
Middle Name:JAMES
Last Name:SMITH
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 N ARLINGTON AVE
Mailing Address - Street 2:SUITE 525
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4505
Mailing Address - Country:US
Mailing Address - Phone:775-323-7500
Mailing Address - Fax:775-789-9208
Practice Address - Street 1:645 N ARLINGTON AVE
Practice Address - Street 2:SUITE 525
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4505
Practice Address - Country:US
Practice Address - Phone:775-323-7500
Practice Address - Fax:775-789-9208
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA955363A00000X
NV955363AS0400X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVPA00876OtherPHARMACY CERTIFICATE
NV1070408OtherNCCPA CERTIFICATE
NVMS1349100OtherDEA CERTIFICATE
NVMS1349100OtherDEA CERTIFICATE
NVPA00876OtherPHARMACY CERTIFICATE