Individual
MARSHALL E. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 N MEDICAL DR, SALT LAKE CITY, UT 84113-1103
(801) 581-2121
Mailing address
PO BOX 581094, SALT LAKE CITY, UT 84158-1094
(801) 581-2121
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
333284-1205
UT
207YP0228X
Pediatric Otolaryngology Physician
Primary
333284-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805065800
—
ID
01
—
990009279
RAILROAD MEDICARE
UT
05
—
D1815
—
UT
Enumeration date
10/13/2006
Last updated
11/17/2021
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