Individual
MILTON R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
401 9TH AVE NW, WATERTOWN, SD 57201-1548
(605) 882-2630
(605) 882-0447
Mailing address
PO BOX 170, WATERTOWN, SD 57201-0170
(605) 882-2630
(605) 882-0447
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0402
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4995950
BCBS
SD
05
—
523390900
—
MN
05
—
6826413
—
SD
Enumeration date
07/26/2006
Last updated
12/07/2011
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