DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. NICHOLAS KENNETH SMYTHE III, PH.D. IN PROGRESS

Active Sole Proprietor

2472E0500X · CANNON AFB, NM

Registration Details

NPI Number
1043035686
Provider Type
Individual
Gender
Male
NPI Issued
Nov 19, 2024 (1.4221431353528 yrs)
Last Updated
Nov 19, 2024
Sole Proprietor
Yes

Practice Information

Address
224 W D.L. INGRAM AVENUE, BLDG. 1408
CANNON AFB, NM, 88103
Browse NM providers · Browse ZIP 88103
Phone
3343901795
Primary Specialty
2472E0500X
2472E0500X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.