Organization
MIDWEST OTOLOGIC GROUP, P.C.
Active
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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