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Individual

WALLACE AUSTIN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
383 S 300 E, ST GEORGE, UT 84770-3620
(435) 628-2826
(435) 628-2839
Mailing address
383 S 300 E, ST GEORGE, UT 84770-3620
(435) 628-2826
(435) 628-2839

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
16478
NV
207N00000X
Dermatology Physician
Primary
9791675-1205
UT

Other

Enumeration date
04/12/2012
Last updated
09/27/2016
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