Individual
DR. DANIEL PHILIP WISER SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3385 POTOMAC WAY, IDAHO FALLS, ID 83404-4978
(208) 522-7246
Mailing address
2425 S 60TH E, IDAHO FALLS, ID 83406-8022
(208) 351-3214
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
O-0782
ID
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
O-0782
ID
207LP2900X
Pain Medicine (Anesthesiology) Physician
OP60530576
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2010
Last updated
03/19/2024
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