Individual
DONALD D SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1233 E 2ND ST, CASPER, WY 82601-2926
(307) 577-7201
Mailing address
1233 E 2ND ST, CASPER, WY 82601-2926
(307) 577-7201
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2947A
WY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
2947A
WY
207RP1001X
Pulmonary Disease Physician
2947A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101905800
—
WY
01
—
290005529
RR MEDICARE
WY
01
—
305615
BLUE SHIELD
WY
01
—
P00764855
RR MCR
WY
Enumeration date
12/30/2005
Last updated
05/26/2011
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