Organization
STEPHEN A. SMITH, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN A. SMITH M.D. (PHYSICIAN)
(719) 545-9292
Entity
Organization
Contact information
Practice address
1600 N GRAND AVE, SUITE 120, PUEBLO, CO 81003-2700
(719) 545-9292
(719) 545-9191
Mailing address
1600 N GRAND AVE, SUITE 120, PUEBLO, CO 81003-2700
(719) 545-9292
(719) 545-9191
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
38322
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32085346
—
CO
01
—
FM543141
BCBS
—
01
—
P00161335
RR MEDICARE
—
Enumeration date
04/20/2007
Last updated
01/07/2008
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