Smith, Brad D
Smith, Brad D is an individual health care provider with primary practice located at 2805 Valencia Dr , Idaho Falls ID 83404-7597. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Smith, Brad D can be contacted via phone (208) 552-3184.Contact Information
Primary practice address
2805 Valencia Dr
Idaho Falls ID 83404-7597
Phone: (208) 552-3184
Fax: (208) 525-6151
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | O 0374 | Idaho |
Profile Details
| NPI number | 1144243767 |
|---|---|
| LBN Legal business name | Smith, Brad D |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 25th, 2006 |
| Last updated | Jan 4th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144243767 | NPPES |
| Idaho | MEDICAID | 807431800 |
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