Individual
DR. KRISTI JOHNSON SMOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
500 CHIPETA WAY, MAIL STOP 115-G04, SALT LAKE CITY, UT 84108
(801) 583-2787
(801) 585-3831
Mailing address
500 CHIPETA WAY, MAIL STOP 115-G04, SALT LAKE CITY, UT 84108
(801) 583-2787
(801) 585-3831
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
Primary
5756815-1205
UT
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
5756815-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P009708556
RAILROAD MEDICARE
UT
Enumeration date
10/26/2007
Last updated
11/23/2021
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