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Individual

HOMER REDD SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1200 E 3900 S, SALT LAKE CITY, UT 84124-1300
(801) 993-9530
(801) 733-5618
Mailing address
1954 FORT UNION BLVD, SALT LAKE CITY, UT 84121-6800
(801) 993-9530

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
166620-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107005414101
IHC
UT
01
2000002
UNITED HEALTHCARE
UT
01
24158
PEHP
UT
01
36243
DESERET MUTUAL
UT
05
52571
UT
01
870482642SM1
EDUCATORS MUTUAL
UT
01
PR07115
MOLINA
UT
01
QMXAF02218
ALTIUS
UT
Enumeration date
09/20/2006
Last updated
07/09/2007
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