Individual
MR. DOUGLAS KENT SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP,PA
Contact information
Practice address
1354 N NEWCOMB ST, PORTERVILLE, CA 93257-9588
(559) 333-0365
Mailing address
PO BOX 630, PORTERVILLE, CA 93258-0630
(559) 333-0365
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA12304
CA
363LF0000X
Family Nurse Practitioner
Primary
RN376101
CA
Other
Enumeration date
05/23/2007
Last updated
05/07/2015
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