Individual
LESLIE P SMOLUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1110 N 18TH ST, SUITE 3, SPRINGFIELD, OR 97477-4200
(541) 726-6447
(541) 726-7704
Mailing address
1110 N 18TH ST, SUITE 3, SPRINGFIELD, OR 97477-4200
(541) 726-6447
(541) 726-7704
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD10512
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184465
—
OR
Enumeration date
06/17/2006
Last updated
07/08/2007
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