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NPI Code Detail

MEDICARE: DR. DUSTIN L SMOOT MD

MEDICARE:  DR. DUSTIN L SMOOT  MD
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
12086S0102XSurgical Critical Care Physician8026SD

General Provider Information

NPI Number : 1760578975
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DUSTIN L SMOOT MD
Provider Business Mailing Address
First Line : 911 E 20TH ST
Second Line : STE 700
City : SIOUX FALLS
State : SD
Zip : 57105-1049
Country : US
Telephone Number : 515-875-9925
Fax Number : 515-875-9923
Provider Business Practice Location Address
First Line : 911 E 20TH ST STE 700
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57105-1049
Country : US
Telephone Number : 605-334-0393
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 06/03/2019

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Directions to “ DR. DUSTIN L SMOOT MD” Practice Location

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