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General NPI Number Information
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NPI Number | 1598846826
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Entity Type | Individual
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Provider Name | CAMILLE SMITH D.O.
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Gender | Female
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 370 N HAVEN DR STE 101
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City | TWIN FALLS
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State | ID
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Zip | 83301-5788
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Country | US
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Telephone | 208-733-1112
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Fax | 208-732-1212
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Provider Business Mailing Address
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Address Line | 370 N HAVEN DR STE 101
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City | TWIN FALLS
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State | ID
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Zip | 83301-5788
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Country | US
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Telephone | 208-732-2200
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Fax | 208-732-2201
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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-0503
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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 | TL-2146
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License Number State | CO
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