Individual
CHARLES JACKSON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 N 7TH ST, BISMARCK, ND 58501-4436
(701) 323-6000
(701) 323-5709
Mailing address
PO BOX 5501, BISMARCK, ND 58506-5501
(701) 323-6000
(701) 323-5709
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
9851
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13238
—
ND
Enumeration date
11/28/2006
Last updated
07/08/2007
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