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General NPI Number Information
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NPI Number | 1598779746
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Entity Type | Individual
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Provider Name | GAYLE DIANE SMITH DO
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Gender | Female
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 15622 N HIGHWAY 41
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City | RATHDRUM
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State | ID
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Zip | 83858-8710
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Country | US
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Telephone | 208-687-4878
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Fax | 208-687-4879
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Provider Business Mailing Address
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Address Line | 1593 E POLSTON AVE
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City | POST FALLS
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State | ID
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Zip | 83854-5326
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Country | US
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Telephone | 208-262-2300
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Fax | 208-262-2349
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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 | O-0506
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License Number State | ID
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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 | 1943
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License Number State | ME
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