Individual
BRAD D SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2805 VALENCIA DR, IDAHO FALLS, ID 83404-7597
(208) 552-3184
(208) 525-6151
Mailing address
2805 VALENCIA DR, IDAHO FALLS, ID 83404-7597
(208) 542-2787
(208) 525-6151
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
O 0374
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807431800
—
ID
Enumeration date
07/25/2006
Last updated
01/04/2018
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