Individual
MR. LOUIS MICHAEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
22301 W ALSOP RD, WASILLA, AK 99623-5023
(907) 864-8100
Mailing address
22301 W ALSOP RD, WASILLA, AK 99623-5023
(907) 864-8100
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1182
AK
363AM0700X
Medical Physician Assistant
2321
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1613061
—
AK
Enumeration date
03/17/2014
Last updated
04/03/2019
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