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MR. DELMAR WALLACE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
2000 AMERICAN LEGION BLVD, MOUNTAIN HOME, ID 83647-3138
(208) 587-1500
(208) 587-3180
Mailing address
2000 AMERICAN LEGION BLVD, MOUNTAIN HOME, ID 83647-3138
(208) 587-1500
(208) 587-3180

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-265
ID

Other

Enumeration date
01/31/2006
Last updated
02/25/2008
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