Mark Alan Smith is a Podiatrist in Peoria, Illinois. Mark Alan Smith practices all healthcare services and medical treatments related to Podiatrist. The NPI Number for Mark Alan Smith is 1093885378. The last update date is 2009-12-03.
Mark Alan Smith's current location address is 3322 W Willow Knolls Dr, Peoria, Illinois. You can contact this provider via phone number 3096915800 and fax number 3096911336. The mailing address for Mark Alan Smith is 3322 W Willow Knolls Dr, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark Alan Smith |
|---|---|
| Address | 3322 W Willow Knolls Dr, Peoria, Illinois |
| Phone Number | 3096915800 |
| Fax Number | 3096911336 |
| Sole Proprietor | N |
| Credentials | DPM |
NPI Number Detail
| NPI Number | 1093885378 |
|---|---|
| Provider Enumeration Date | 2006-11-08 |
| Last Updated Date | 2009-12-03 |
Provider Mailing Address Detail
| Address | 3322 W Willow Knolls Dr |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 61614 |
| Phone Number | 3096915800 |
| Fax Number | 3096911336 |
Provider's Primary Taxonomy Detail
| Speciality | Podiatrist |
|---|---|
| Taxonomy | 213E00000X |
| Licence No | 16004790 |
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Definition: A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 16004790 | IL | -- | |
| 7215174 | IL | BLUE CROSS BLUE SHIELD | |
| 928270 | IL | MEDICARE PROVIDER | |
| 480022534 | IL | RAILROAD MEDICARE |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Mark Alan Smith by the Centers for Medicare & Medicaid Services?
The Mark Alan Smith has been assigned the NPI (National Provider Identifier) 1093885378 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you kindly provide the complete physical address where Mark Alan Smith's facilities are geographically located?
The facilities of Mark Alan Smith are physically situated at the following location: 3322 W Willow Knolls Dr, Peoria, IL, 61614.
What is the area of specialization for Mark Alan Smith, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Mark Alan Smith is Podiatrist, and the corresponding taxonomy code that categorizes this area of expertise is 213E00000X.
On what date did the Mark Alan Smith receive its 1093885378 assignment from the Centers for Medicare & Medicaid Services?
The Mark Alan Smith was assigned its 1093885378 by the Centers for Medicare & Medicaid Services on 2006-11-08.
When was the information pertaining to Mark Alan Smith most recently updated or revised?
The details related to Mark Alan Smith, including its address, specialty, and other relevant information, were last updated or revised on 2009-12-03.