Individual
BRUCE MICHAEL SMITH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2121 E HARMONY RD, SUITE 350, FORT COLLINS, CO 80528-3404
(970) 484-6373
(970) 484-0382
Mailing address
2121 E HARMONY RD, SUITE 350, FORT COLLINS, CO 80528-3404
(970) 484-6373
(970) 484-0382
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
22552
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01225523
—
CO
05
—
107665500
—
WY
01
—
22552
COLORADO LICENSE #
CO
01
—
2913A
WYO. LICENSE #
WY
Enumeration date
01/24/2006
Last updated
11/05/2020
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