Individual
TAYLOR DREW SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPH, PA-C
Contact information
Practice address
187 E 13TH ST, IDAHO FALLS, ID 83404-5305
(208) 497-0500
(208) 497-0198
Mailing address
960 LOST RIVER RD, IDAHO FALLS, ID 83401-5724
(208) 821-2402
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1774
ID
Other
Enumeration date
10/06/2019
Last updated
10/06/2019
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