Individual
DR. RANDAL MARK SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
2424 E CLAIRMONT AVE, EAU CLAIRE, WI 54701-6773
(715) 834-7380
(715) 834-1034
Mailing address
111 CANTERBURY ROAD, EAU CLAIRE, WI 54701-7105
(715) 552-1752
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
042252
MO
183500000X
Pharmacist
Primary
13807-040
WI
183500000X
Pharmacist
9562
OK
Other
Enumeration date
06/29/2010
Last updated
06/29/2010
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