Brennen D Smith
Orthopaedic Surgeon Orthopaedic Spine Surgeon
2400 St Francis Dr
Breckenridge
, Minnesota 56520-1025
Brennen D Smith
Orthopaedic Surgeon Orthopaedic Spine Surgeon
2400 St Francis Dr
Breckenridge
, Minnesota 56520-1025
(937) 599-1730
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About
Features
Specialties
- Orthopaedic Surgeon
- Orthopaedic Spine Surgeon
Languages spoken
- English
Location
First Address
- Brennen D Smith
- 4784 Amber Valley Pkwy S Chi Provider Enrollment - Fargo Divison
- Fargo, ND
- Zip : 58104-8614
- Fax : (937) 599-1730
- Phone : (701) 237-8072
Second Address
- Brennen D Smith
- 2400 St Francis Dr
- Breckenridge, MN
- Zip : 56520-1025
- Fax : (218) 643-0850
- Phone : (218) 643-3000
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgeon | 15379 | ND |
| N | 207XS0117X | Orthopaedic Spine Surgeon | 34.010178 | OH |
| Y | 207XS0117X | Orthopaedic Spine Surgeon | 61204 | MN |
National Provider Identifier
| NPI | 1376753277 |
|---|---|
| Provider Name | Brennen D Smith |
| First Address | Fargo, ND 58104-8614 |
| Second Address | Breckenridge, MN 56520-1025 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/05/2007 |
| Last Update Date | 02/10/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000480404 | OH MEDICAID UNISON (01) | OH |
| 1471472 | (05) | ND |
| 3158630 | (05) | OH |
| 3810022462 | (05) | WV |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.