Healthcare Provider Details

I. General information

NPI: 1396835351
Provider Name (Legal Business Name): PAUL CHRISTOPHER SMITH PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 COURT ST
PUEBLO CO
81003-2715
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE
LOVELAND CO
80538-8702
US

V. Phone/Fax

Practice location:
  • Phone: 719-562-2300
  • Fax: 719-562-2095
Mailing address:
  • Phone: 970-624-2403
  • Fax: 970-490-4173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0002971
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA205464
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA.0002971
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA9103469
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA10004323
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA2005-0034
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: