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NPI Code Detail

MEDICARE: DEBRA SMITH PA-C

MEDICARE: DEBRA SMITH PA-C
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
1363A00000XPhysician Assistant1084IA

General Provider Information

NPI Number : 1962499368
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA SMITH PA-C
Provider Business Mailing Address
First Line : 3600 30TH ST
Second Line :
City : DES MOINES
State : IA
Zip : 50310-5753
Country : US
Telephone Number : 515-699-5999
Fax Number : 515-699-5929
Provider Business Practice Location Address
First Line : 3600 30TH ST
Second Line :
City : DES MOINES
State : IA
Zip : 50310-5753
Country : US
Telephone Number : 515-699-5999
Fax Number : 515-699-5929
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2005
Last Update Date : 03/13/2013

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Directions to “ DEBRA SMITH PA-C” Practice Location

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