Individual
JOLENE M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
12499 UNIVERSITY AVE STE 280, CLIVE, IA 50325-8288
(515) 245-6425
Mailing address
300 ABIGAIL LN, WAUKEE, IA 50263-8746
(612) 239-8673
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
54268
MN
207L00000X
Anesthesiology Physician
DO-04738
IA
207LP2900X
Pain Medicine (Anesthesiology) Physician
54268
MN
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
DO-04738
IA
Other
Enumeration date
06/17/2010
Last updated
10/22/2024
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