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Organization

SERENA SMITH MD FP PROFESSIONAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SERENA L SMITH MD (OWNER)
(970) 874-4473
Entity
Organization

Contact information

Practice address
311 PALMER STREET, DELTA, CO 81416
(970) 874-4473
(970) 874-8681
Mailing address
311 PALMER STREET, DELTA, CO 81416
(970) 874-4473
(970) 874-8681

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41212
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
92127282
CO
Enumeration date
05/04/2007
Last updated
10/13/2011
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