Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 38808 | IA |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MT186055 | PA |
NPI | 1083874853 |
---|---|
Provider Name | Jeffrey Ryan Smit |
First Address | Des Moines, IA 50305-4925 |
Second Address | Clive, IA 50325-7007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2008 |
Last Update Date | 20/07/2010 |