Individual
BRENT A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(800) 243-1455
Mailing address
PO BOX 858, HERSHEY, PA 17033-0858
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS008033L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001708001
—
PA
Enumeration date
06/14/2005
Last updated
11/20/2013
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