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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. DELMAR WALLACE SMITH, P.A.

Active

Medical Physician Assistant · MOUNTAIN HOME, ID

Registration Details

NPI Number
1336110980
Provider Type
Individual
Gender
Male
NPI Issued
Jan 31, 2006 (20.22209781889 yrs)
Last Updated
Feb 25, 2008
License
PA-265 (ID)

Practice Information

Address
2000 AMERICAN LEGION BLVD
MOUNTAIN HOME, ID, 836473138
Browse ID providers · Browse ZIP 83647
Phone
2085871500
Fax
2085873180
Primary Specialty
Medical Physician Assistant
363AM0700X

Other Medical Physician Assistant Providers in MOUNTAIN HOME, ID

Name Credential NPI
KYLE HOLLENBACK 1932574381
MR. DIRK KENNETH BASKETT PA-C 1841920220
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.