NPI 1336110980

Delmar Wallace Smith, PA

Practitioner Medical Physician Assistant Mountain Home, ID

Practice location

Address: 2000 American Legion Blvd, Mountain Home, ID 83647-3138
Phone: (208) 587-1500
Fax: (208) 587-3180

Registered specialties

Medical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence PA-265 (ID)

Other Physician Assistant providers in Idaho →

Registry record

NPI: 1336110980
Entity type: Individual
Sex (as registered): Male
NPI issued: 31 Jan 2006
Record last updated: 25 Feb 2008

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.