Individual
PAUL G SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2827 FORT MISSOULA RD, COMMUNITY MEDICAL CENTER, MISSOULA, MT 59804-7408
(406) 327-4086
(406) 327-4547
Mailing address
2827 FORT MISSOULA RD, COMMUNITY MEDICAL CENTER, MISSOULA, MT 59804-7408
(406) 327-4086
(406) 327-4547
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
35-003296
OH
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
34-003296
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000028209
ANTHEM
OH
01
—
000000221263
UNISON
OH
01
—
000000526139
ANTHEM
OH
01
—
01926585
NY MEDICAID
NY
05
—
0509346
—
OH
05
—
1023418340001
—
PA
01
—
364031
WELLCARE
OH
01
—
509346
BCMH
OH
01
—
647555
AETNA
OH
01
—
744702
BUCKEYE
OH
Enumeration date
07/21/2006
Last updated
04/28/2015
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