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Individual
DR. RANDALL SMART
Active
Individual
DR. RANDALL SMART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
3984
AK
207R00000X
Internal Medicine Physician
Primary
G61777
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G617770
—
CA
Enumeration date
06/26/2006
Last updated
02/14/2014
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