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General NPI Number Information
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NPI Number | 1790385128
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Entity Type | Individual
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Provider Name | RAYMOND ARTHUR SMITH PHARMD, PH.D
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Gender | Male
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Dates
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Enumeration Date | 10/26/2020
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | 2900 ROOSEVELT RD
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City | MARINETTE
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State | WI
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Zip | 54143-4299
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Country | US
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Telephone | 715-735-5593
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Fax |
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Provider Business Mailing Address
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Address Line | 712 CHAUTAUQUA ST
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City | MARINETTE
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State | WI
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Zip | 54143-4214
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Country | US
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Telephone | 715-735-9984
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 13848-40
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License Number State | WI
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