| Doctor Name: | BRETT A SMITH |
| NPI Number: | 1932180668 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | PA-422 |
| Business Practice Address: | 300 S 3rd W Soda Springs, ID - 832761561 |
| Business Phone Number: | 2085473118 |
| Business Fax Number: | 2085470424 |
| Mailing Address: | 300 S 3rd W, SODA SPRINGS |
| State: | ID |
| Postal Code: | 832761559 |
| Phone Number: | 2085473118 |
| Fax Number: | 2085470424 |
| NPI Enumeration Date: | 11/09/2005 |
| NPI Last Update Date: | 03/08/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA-422 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |