Provider Demographics
NPI:1528156163
Name:SMITH, WILLIAM E JR (D C)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:E
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 ROCHESTER ST
Mailing Address - Street 2:P. O. BOX 36 A
Mailing Address - City:LIMA
Mailing Address - State:NY
Mailing Address - Zip Code:14485-9463
Mailing Address - Country:US
Mailing Address - Phone:585-624-7470
Mailing Address - Fax:585-624-7844
Practice Address - Street 1:1450 ROCHESTER ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:NY
Practice Address - Zip Code:14485-9463
Practice Address - Country:US
Practice Address - Phone:585-624-7470
Practice Address - Fax:585-624-7844
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCH002466111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP01002466Medicare UPIN