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General NPI Number Information
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NPI Number | 1871663443
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Entity Type | Organization
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Legal Business Name | PULMONARY AND PRIMARY CARE ASSOCIATES
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 11/25/2009
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Provider Practice Location Address
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Address Line | 1711 S STEPHENSON AVE SUITE 215
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City | IRON MOUNTAIN
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State | MI
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Zip | 49801-3639
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Country | US
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Telephone | 906-779-7050
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Fax | 906-774-3325
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Provider Business Mailing Address
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Address Line | 1711 S STEPHENSON AVE SUITE 215
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City | IRON MOUNTAIN
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State | MI
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Zip | 49801-3639
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Country | US
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Telephone | 906-779-7050
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Fax | 906-774-3325
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CARL ASHLEY SMOOT
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Credential | D.O, D.A.B.S.M,
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Telephone | 906-776-5845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | CS006908
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | CS006908
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License Number State | MI
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