Individual
GREGORY B SMITH
Active
Individual
GREGORY B SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
5355080-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107031310101
IHC
UT
01
—
16-00712
UNITED HEALTHCARE
UT
01
—
219637
ALTIUS
UT
01
—
78938
PEHP
UT
01
—
868806
DMBA
UT
05
—
870281028000
—
UT
01
—
870281028GBS
EMIA
UT
01
—
P00148585
PALMETTO GBA
—
Enumeration date
06/20/2006
Last updated
11/27/2023
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