Individual
DR. JOHN P SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-4870
(801) 213-2799
Mailing address
1805 NOBLE ST, EAST MEADOW, NY 11554-4018
(801) 369-5201
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
281818
NY
208800000X
Urology Physician
Primary
5554051-1204
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2014
Last updated
11/17/2021
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