Brad D Smith, DO, PA

Organization Active NPI Surgery Physician · Idaho Falls, ID

NPI 1336246701 · NPPES record last updated Aug 12, 2010

Key facts

NPI
1336246701
Entity type
Organization (NPI type 2)
Primary specialty
Surgery Physician 208600000X
License
O-0374 (ID)
Legal business name
BRAD D SMITH, DO, PA
Practice address
2805 Valencia Drive
Idaho Falls, ID 83404
Phone
(208) 542-2787
Fax
(208) 252-6151
NPI assigned
Sep 20, 2006
Organization subpart
No

Authorized official

Name
Brad D Smith, D.O.
Title
President
Phone
(208) 542-2787

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208600000X O-0374 ID Yes

Addresses

Primary practice location

2805 Valencia Drive
Idaho Falls, ID 83404

Mailing address

3622 Stonebrook LN
Idaho Falls, ID 83404-7903
Phone (208) 542-2787

Other providers in Idaho Falls, ID

All providers in Idaho Falls, ID · Surgery Physician in Idaho

Sources for this page

Verify at the official NPI Registry.