Smith, Stacey A

Smith, Stacey A is an individual health care provider with primary practice located at 211 E Mill St , Pelican Rapids MN 56572-4234. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Smith, Stacey A can be contacted via phone (218) 863-6100.

Contact Information

Primary practice address
211 E Mill St Pelican Rapids MN 56572-4234
Phone: (218) 863-6100
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 44095 Minnesota

Profile Details

NPI number 1649210832
LBN Legal business name Smith, Stacey A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2006
Last updated Nov 28th, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649210832 NPPES
Minnesota Other 0107063 MEDICA #
Minnesota Other 20696 MEDICA #
Minnesota MEDICAID 677682500 MEDICA #
Minnesota Other 1280970 MEDICA #
Minnesota Other 43G89SM MEDICA #
Minnesota Other 0107064 MEDICA #
Minnesota Other 142065 MEDICA #
Minnesota Other DA9031028234 MEDICA #
Minnesota MEDICAID 11146 MEDICA #
Minnesota Other HP38211 MEDICA #
Minnesota Other MN100045 MEDICA #

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