Provider Demographics
NPI:1144294638
Name:SMITH, VERNON MILAN JR (MD)
Entity type:Individual
Prefix:DR
First Name:VERNON
Middle Name:MILAN
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1805 KIPLING ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-1477
Mailing Address - Country:US
Mailing Address - Phone:303-232-7660
Mailing Address - Fax:303-232-9247
Practice Address - Street 1:1805 KIPLING ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-1477
Practice Address - Country:US
Practice Address - Phone:303-232-7660
Practice Address - Fax:303-232-9247
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
CO24860207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01248608Medicaid
CO24860OtherCOLORADO
AS1848297OtherDEA
CO01248608Medicaid
COC299418Medicare PIN