Individual
STEPHEN MAX SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
611 CLINIC ROAD, CHALLIS, ID 83226
(208) 879-4351
(208) 879-5216
Mailing address
PO BOX 980, CHALLIS, ID 83226-0980
(208) 879-4351
(208) 879-5216
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1321
ID
Other
Enumeration date
12/19/2011
Last updated
07/21/2020
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