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General NPI Number Information
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NPI Number | 1063616720
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Entity Type | Organization
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Legal Business Name | RONDA DENNIS-SMITHART, MD, PC
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 09/27/2013
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Provider Practice Location Address
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Address Line | 1417 A AVE E SUITE 100
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City | OSKALOOSA
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State | IA
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Zip | 52577-4202
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Country | US
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Telephone | 641-673-7537
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Fax | 641-673-5235
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Provider Business Mailing Address
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Address Line | 1417 A AVE E SUITE 100
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City | OSKALOOSA
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State | IA
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Zip | 52577-4202
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Country | US
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Telephone | 641-673-7537
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Fax | 641-673-5235
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. MIKE A SMITHART
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Credential |
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Telephone | 641-673-7537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 24808
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License Number State | IA
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