Individual
CHARLES F SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1000 MINERAL POINT AVE, JANESVILLE, WI 53548-2940
(608) 756-6000
Mailing address
1000 MINERAL POINT AVE, JANESVILLE, WI 53548-2940
(608) 756-6000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
109611
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02818100
—
MN
05
—
43367200
—
WI
01
—
94D44SM
BCBSMN
MN
Enumeration date
04/19/2007
Last updated
05/30/2008
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