Brad D Smith, Do, Pa

NPI 1336246701 - Surgery - 208600000X

NPI Details
NPI 1336246701
Enumeration Date 09/20/2006
Last Updated 08/12/2010
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name BRAD D BRAD
Position PRESIDENT
Phone (208) 542-2787
Fax (208) 252-6151
Practice Location
2805 VALENCIA DRIVE
IDAHO FALLS ID, 83404, US
Phone (208) 542-2787
Fax (208) 252-6151
Business Location
3622 STONEBROOK LN
IDAHO FALLS ID, 83404-7903, US
Phone (208) 542-2787
Fax (208) 525-6151
Toxanomy
Taxonomy Code 208600000X
License State Idaho
License Number O-0374
Remove 1336246701 NPI Number
 

According to our database, Brad D Smith, Do, Pa NPI is 1336246701, taxonomy code is 208600000X and license number is O-0374, license state is located at Idaho. Brad D Smith, Do, Pa physically located at 2805 Valencia Drive, Idaho Falls ID, 83404. NPI Number 1033115704 has the healthcare provider type.

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1336246701 NPI number is provided on an as is basis without warranty of any kind. 1336246701 is maintained by the National Plan & Provider Enumeration System. The contents of Brad D Smith, Do, Pa are for informational purposes only.