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General NPI Number Information
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NPI Number | 1508966581
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Entity Type | Individual
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Provider Name | PHILIP G SMITH MD
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Gender | Male
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 04/01/2021
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Provider Practice Location Address
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Address Line | 1100 GOETHALS DRIVE 2ND FLOOR KADLEC CLINIC GENERAL & COLORECTAL SURGERY
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City | RICHLAND
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State | WA
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Zip | 99352-3304
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Country | US
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Telephone | 509-942-3185
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Fax | 509-946-1850
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Provider Business Mailing Address
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Address Line | 3900 S ZINTEL WAY
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City | KENNEWICK
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State | WA
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Zip | 99338
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Country | US
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Telephone | 509-942-3627
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Fax | 509-942-2268
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD60119652
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License Number State | WA
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