Gary Lyle Smith CRNA

NPI 1063507077 - Nurse Anesthetist, Certified Registered - 367500000X

NPI Details
NPI 1063507077
Gender Male
Enumeration Date 10/04/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
1800 SPRING RIDGE DR
SUSANVILLE CA, 96130-6100, US
Phone (530) 252-2000
Fax
Business Location
1441 N 12TH ST
PHOENIX AZ, 85006-2837, US
Phone (602) 747-4577
Fax
Toxanomy
Taxonomy Code 367500000X
License State California
License Number 2065
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According to our database, Gary Lyle Smith CRNA NPI is 1063507077, taxonomy code is 367500000X and license number is 2065, license state is located at California. Gary Lyle Smith CRNA physically located at 1800 Spring Ridge Dr, Susanville CA, 96130-6100. NPI Number Gary Lyle Smith CRNA has the Individual type.

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1063507077 NPI number is provided on an as is basis without warranty of any kind. 1063507077 is maintained by the National Plan & Provider Enumeration System. The contents of Gary Lyle Smith CRNA are for informational purposes only.