Organization
STACY R SMITH MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY R SMITH M.D. (PHYSICIAN)
(801) 424-3090
Entity
Organization
Contact information
Practice address
1548 E 4500 S, STE 105, SALT LAKE CITY, UT 84117-4209
(801) 424-3090
(801) 424-3091
Mailing address
1548 E 4500 S, STE 105, SALT LAKE CITY, UT 84117-4209
(801) 424-3090
(801) 424-3091
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
60248791205
UT
Other
Enumeration date
07/27/2012
Last updated
05/13/2013
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