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Individual

DR. HENRY THOMAS SMITH

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
230 EAST BROADWAY, JACKSON, WY 83001
(307) 733-1122
(307) 734-9577
Mailing address
PO BOX 8760, JACKSON, WY 83002-8760
(307) 733-1122
(307) 734-9577

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
5592A
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
303832
BLUE CROSS BLUE SHIELD
WY
Enumeration date
06/24/2005
Last updated
07/08/2007
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