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NPI Code Detail

MEDICARE: MR. LONNIE DOYLE SMITH PHARMD

MEDICARE: MR. LONNIE DOYLE SMITH PHARMD
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
11835P1200XPharmacotherapy Pharmacist361517-1701UT

General Provider Information

NPI Number : 1750388104
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LONNIE DOYLE SMITH PHARMD
Provider Business Mailing Address
First Line : 3486 S 3125 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84109-3140
Country : US
Telephone Number : 801-484-5896
Fax Number : 801-585-5640
Provider Business Practice Location Address
First Line : 50 N MEDICAL DR
Second Line : RM PA455
City : SALT LAKE CITY
State : UT
Zip : 84132-0001
Country : US
Telephone Number : 801-585-2641
Fax Number : 801-585-5640
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 07/08/2007

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