Individual
MATTHEW A. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2055 N MAIN ST., TOOELE, UT 84074
(435) 843-3600
Mailing address
PO BOX 268, BOUNTIFUL, UT 84011-0268
(801) 296-2113
(801) 296-1715
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
722182
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114011905
—
UT
05
—
147826100
—
TX
01
—
147826101
FIRSTCARE COMMERCIAL
TX
05
—
180263901
—
TX
05
—
200074480A
—
OK
01
—
202004760
PRESBYTERIAN COMMERCIAL
NM
05
—
202004760
—
NM
05
—
42324777
—
NM
05
—
67417
—
TX
01
—
86048U
HMO BLUE
TX
01
—
86049U
BC/BS
TX
Enumeration date
10/03/2006
Last updated
02/19/2009
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