Individual
DAVID J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-AA
Contact information
Practice address
1008 MINNEQUA AVE, PUEBLO, CO 81004-3733
(719) 557-4221
(719) 557-3834
Mailing address
1008 MINNEQUA AVE, PUEBLO, CO 81004-3733
(719) 557-4221
(719) 557-3834
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
880
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07008808
—
CO
Enumeration date
07/13/2005
Last updated
04/20/2017
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