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Individual

ELIZABETH R SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
5685 INLAND SHORES WAY N, KEIZER, OR 97303
(503) 779-2271
Mailing address
5685 INLAND SHORES WAY N, KEIZER, OR 97303-3794
(503) 779-2271

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
28203
NE
207Q00000X
Family Medicine Physician
Primary
MD190294
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500764615
OR
Enumeration date
06/11/2013
Last updated
09/18/2019
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