Provider Demographics
NPI:1144540667
Name:SMITH, ERIC DAVIS (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:DAVIS
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 HENDERSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2868
Mailing Address - Country:US
Mailing Address - Phone:828-771-4223
Mailing Address - Fax:
Practice Address - Street 1:1914 SMOKY PARK HWY
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715
Practice Address - Country:US
Practice Address - Phone:828-418-0040
Practice Address - Fax:828-418-0041
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2013-00127207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1144540667Medicaid
NCNCD621AMedicare PIN