Individual
J PATRICK SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
775 PRAIRIE CENTER DR, SUITE 250, EDEN PRAIRIE, MN 55344-7314
(952) 944-2519
(952) 944-0460
Mailing address
6465 WAYZATA BLVD, SUITE 900, ST LOUIS PARK, MN 55426-1728
(952) 512-5600
(952) 512-5650
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
24520
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
73B26SM
BLUECROSS BLUESHIELD
—
01
—
912996
MEDICA
—
01
—
969990824013
PREFERREDONE
—
01
—
HP14427
HEALTHPARTNERS
—
Enumeration date
08/11/2006
Last updated
07/11/2007
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