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General NPI Number Information
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NPI Number | 1144202730
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Entity Type | Individual
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Provider Name | CANDICE N SMITH MD
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Gender | Female
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 05/03/2023
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Provider Practice Location Address
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Address Line | 307 E SCENIC VALLEY AVE
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City | INDIANOLA
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State | IA
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Zip | 50125-4865
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Country | US
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Telephone | 515-961-8448
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Fax | 515-643-9100
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Provider Business Mailing Address
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Address Line | PO BOX 1475
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City | DES MOINES
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State | IA
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Zip | 50305-1475
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Country | US
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Telephone | 515-961-8448
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Fax | 515-643-9100
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 04-32649
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 52075
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD-38737
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License Number State | IA
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 48402
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License Number State | WI
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