NPI 1336246701

Brad D Smith, DO, PA

Organisation Surgery Physician Idaho Falls, ID

Practice location

Address: 2805 Valencia Drive, Idaho Falls, ID 83404
Phone: (208) 542-2787
Fax: (208) 252-6151
Mailing address: 3622 Stonebrook Ln, Idaho Falls, ID 83404-7903

Authorised official

Name: Brad D Smith
Title: President
Phone: (208) 542-2787

Registered specialties

Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208600000X Licence O-0374 (ID)

Other Surgery providers in Idaho →

Registry record

NPI: 1336246701
Entity type: Organization
NPI issued: 20 Sep 2006
Record last updated: 12 Aug 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.