MR. LARRY DERRELL SMITH PA-C NPI 1558332650

NPI Information

NPI: 1558332650
Provider Name: MR. LARRY DERRELL SMITH, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
2450 SISTER MARY COLUMBA DR
RED BLUFF, CA
ZIP 96080
Phone: (530) 527-0414
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MR. Larry Derrell Smith, PA-C is a surgical physician assistant in Red Bluff, CA with 30 years of experience. MR. Larry Derrell Smith, PA-C NPI is 1558332650. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2450 SISTER MARY COLUMBA DR
RED BLUFF, CA
ZIP 96080-356
Phone: (530) 527-0414
Fax: (530) 527-3720

The NPI 1558332650 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/28/2006 and was last updated on 4/6/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		PA53072	CALIFORNIA	No
2	363AS0400X	Physician Assistant	Surgical	PA53072	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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