Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | R-10907 | IA |
N | 207YP0228X | Pediatric Otolaryngology | R-10907 | IA |
N | 207YS0123X | Facial Plastic Surgeon | R-10907 | IA |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | R-10907 | IA |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | R-10907 | IA |
NPI | 1124556923 |
---|---|
Provider Name | Dr. Ryan Bradley Smith |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2017 |
Last Update Date | 24/05/2017 |