Organization
SMITH CLINIC P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLIVER D SMITH M.D. (OWNER)
(208) 521-5936
Entity
Organization
Contact information
Practice address
3669 ELLENDALE CIR, AMMON, ID 83406-4749
(208) 521-5936
(208) 524-5608
Mailing address
3669 ELLENDALE CIRCLE, IDAHO FALLS, ID 83406
(208) 521-5936
(208) 524-5608
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
ID
Other
Enumeration date
07/03/2007
Last updated
02/21/2008
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