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Individual

CAROL ANN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA C

Contact information

Practice address
5950 UNIVERSITY AVENUE, STE 221, WEST DES MOINES, IA 50266
(515) 875-9115
(515) 875-9117
Mailing address
6800 LAKE DRIVE, STE 250, WEST DES MOINES, IA 50266-2504
(515) 875-9925
(515) 875-9923

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1013
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0634816
IA
Enumeration date
07/29/2005
Last updated
09/19/2011
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