Provider Demographics
NPI:1871521294
Name:SMITH, FLOYD AMES JR (MD)
Entity type:Individual
Prefix:DR
First Name:FLOYD
Middle Name:AMES
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8950 W EMERALD ST STE 150
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8296
Mailing Address - Country:US
Mailing Address - Phone:208-400-5131
Mailing Address - Fax:800-994-7357
Practice Address - Street 1:8950 W EMERALD ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-4854
Practice Address - Country:US
Practice Address - Phone:208-400-5131
Practice Address - Fax:208-277-3448
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2024-05-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG8424208600000X
IDM16438208600000X
WAMD60252644208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8907458Medicare PIN