Individual
DR. CARL ASHLEY SMOOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO,FCCP, DABSM
Contact information
Practice address
1711 S STEPHENSON AVE, SUITE 215, IRON MOUNTAIN, MI 49801-3639
(906) 779-7050
(906) 774-3325
Mailing address
1711 S STEPHENSON AVE, SUITE 215, IRON MOUNTAIN, MI 49801-3639
(906) 779-7050
(906) 774-3325
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
CS006908
MI
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
CS006903
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861457889
INDIVIDUAL NPI
MI
01
—
1871663443
GROUP NPI
MI
05
—
2712724
—
MI
05
—
30057800
—
WI
01
—
5220016
MEDICARE PIN PRIOR 2007
MI
01
—
OP39080
MEDICARE GROUP PIN
MI
01
—
P39080001
MEDICARE INDIVIDUAL PIN
MI
Enumeration date
04/20/2006
Last updated
11/25/2009
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