Individual
JOSEPH SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6 13TH AVE E, POLSON, MT 59860-5315
(406) 883-5680
Mailing address
PO BOX 12, LIBERTY LAKE, WA 99019-0012
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD2017-0825
NM
207P00000X
Emergency Medicine Physician
Primary
MED-PHYS-LIC-125346
MT
207P00000X
Emergency Medicine Physician
RS2015-0376
NM
Other
Enumeration date
04/06/2015
Last updated
01/04/2024
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