Individual
CHARLES A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
200 S CODY RD, LE CLAIRE, IA 52753-9579
(563) 289-3008
(563) 289-3024
Mailing address
865 LINCOLN RD, STE L10, BETTENDORF, IA 52722-4159
(563) 355-9191
(563) 355-3419
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02372
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
049407
HEALTH ALLIANCE
—
05
—
1071621
—
IA
01
—
19839
IOWA HEALTH SOLUTIONS
—
01
—
46888
WELLMARK HEALTH PLANS
—
01
—
4796890012
DMERC
—
01
—
IA01C1
JOHN DEERE HEALTH PLAN
—
Enumeration date
06/27/2005
Last updated
06/03/2021
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