Doctor Name: | STEPHEN A SMITH |
NPI Number: | 1275594269 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 17784 |
Business Practice Address: | 1619 N Greenwood St Suite 402 Pueblo, CO - 810032658 |
Business Phone Number: | 7195957760 |
Business Fax Number: | 7195957765 |
Mailing Address: | 1619 N Greenwood St, Suite 402 PUEBLO |
State: | CO |
Postal Code: | 810032658 |
Phone Number: | 7195957760 |
Fax Number: | 7195957765 |
NPI Enumeration Date: | 03/29/2006 |
NPI Last Update Date: | 08/30/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 17784 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |