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Organization

MIDWEST OTOLOGIC GROUP, P.C.

Active
Other names
Peter G. Smith, MD, Peter G. Smith, MD, PhD
Organization subpart
No

Provider details

NPI number
Authorized official
PETER GAILLARD SMITH MD, PHD (PRESIDENT)
(314) 432-5151
Entity
Organization

Contact information

Practice address
621 S NEW BALLAS RD, SUITE 597A, SAINT LOUIS, MO 63141-8232
(314) 432-5151
(314) 432-8795
Mailing address
621 S NEW BALLAS RD, SUITE 597A, SAINT LOUIS, MO 63141-8232
(314) 432-5151
(314) 432-8795

Taxonomy

Speciality
Code
Description
License number
State
207YX0901X
Otology & Neurotology Physician
Primary
MDR8770
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1518961440
PERSONAL NPI
Enumeration date
12/13/2006
Last updated
11/09/2007
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