NPI 1003836701

Roosevelt Smith, PACATR

Practitioner Medical Physician Assistant Winona, MN

Practice location

Address: 62 E 3rd St Suite 3, Winona, MN 55987-3481
Phone: (507) 474-4770
Fax: (507) 474-4774

Registered specialties (2)

Medical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence 9155 (MN)

Other Physician Assistant providers in Minnesota →

Medical Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence 500023 (WI)

Registry record

NPI: 1003836701
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Jul 2006
Record last updated: 8 Jul 2007

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.