Individual
STEPHEN C SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 MERCY DR, SUITE120, COUNCIL BLUFFS, IA 51503-3128
(712) 388-2770
(712) 388-2771
Mailing address
800 MERCY DR, SUITE120, COUNCIL BLUFFS, IA 51503-3128
(712) 388-2770
(712) 388-2771
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21200
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0100130
UNITED HEALTH CARE
—
01
—
080160487
RAILROAD MEDICARE
—
05
—
1191874
—
IA
01
—
20944
WELLMARK
IA
01
—
21071
COVENTRY
—
Enumeration date
11/16/2006
Last updated
01/15/2015
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