Individual
RICHARD J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-3612
(319) 356-4108
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-3612
(319) 356-4108
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
27940
IA
207YP0228X
Pediatric Otolaryngology Physician
Primary
27940
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0069229
—
IA
01
—
02402
WELLMARK BCBS
IA
Enumeration date
08/24/2005
Last updated
12/18/2007
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