Individual
GARY D SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2600 W NORFOLK AVE STE B, NORFOLK, NE 68701-4460
(402) 371-3500
Mailing address
PO BOX 642117, OMAHA, NE 68164-8117
(402) 717-4377
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14350
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47076515446
—
NE
05
—
47076515447
—
NE
Enumeration date
11/14/2006
Last updated
07/08/2007
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