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NPI Code Detail

MEDICARE: CHANCE SMITH

MEDICARE: CHANCE SMITH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician3471067ID

General Provider Information

NPI Number : 1598388019
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANCE SMITH
Provider Business Mailing Address
First Line : 3200 CHANNING WAY STE A206
Second Line :
City : IDAHO FALLS
State : ID
Zip : 83404-7586
Country : US
Telephone Number : 208-529-2230
Fax Number :
Provider Business Practice Location Address
First Line : 3200 CHANNING WAY STE A206
Second Line :
City : IDAHO FALLS
State : ID
Zip : 83404-7586
Country : US
Telephone Number : 208-529-2230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2020
Last Update Date : 06/09/2026

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Directions to “ CHANCE SMITH ” Practice Location

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