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General NPI Number Information
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NPI Number | 1942676598
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Entity Type | Organization
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Legal Business Name | ROBERT F. SMITH, MD, PLLC
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Dates
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Enumeration Date | 08/18/2015
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Last Update Date | 08/31/2015
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Provider Practice Location Address
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Address Line | 320 N COLLINS RD
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City | BOISE
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State | ID
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Zip | 83702-4519
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Country | US
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Telephone | 208-866-2473
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Fax |
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Provider Business Mailing Address
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Address Line | 124 N COSTON ST
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City | BOISE
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State | ID
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Zip | 83712-8101
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Country | US
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Telephone | 208-866-2473
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Fax |
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Authorized Official
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Title or Position | MANAGER/SOLE MEMBER
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Name | DR. ROBERT F. SMITH
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Credential | M.D.
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Telephone | 208-866-2473
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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 | M5963
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License Number State | ID
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