Individual
DEREK SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
4403 HARRISON BLVD, OGDEN, UT 84403-3271
(801) 387-2750
Mailing address
1059 E 2925 N, OGDEN, UT 84414-1772
(801) 668-3998
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/31/2017
Last updated
08/01/2017
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