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Individual

DR. LAURENCE R SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1915 W 5950 S, ROY, UT 84067-1454
(801) 387-8100
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 387-8100

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
781624021205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1053441873
UT
Enumeration date
07/25/2006
Last updated
09/24/2008
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