Individual
DR. JOSHUA MICHAEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3910 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7596
(208) 523-1122
(208) 523-2582
Mailing address
3910 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7596
(208) 523-1122
(208) 523-2582
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
30283
SC
208000000X
Pediatrics Physician
63960
GA
208000000X
Pediatrics Physician
N8989
TX
2080P0205X
Pediatric Endocrinology Physician
Primary
M13504
ID
2080P0205X
Pediatric Endocrinology Physician
N8989
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154528727
—
ID
05
—
312219409
—
TX
05
—
312219410
—
TX
Enumeration date
06/28/2007
Last updated
09/02/2021
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