MR. DELMAR WALLACE SMITH (NPI# 1336110980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336110980 |
| Entity Type | Individual |
| Full Name | MR. DELMAR WALLACE SMITH |
| Credential | P.A. |
| Practice Address |
2000 American Legion Blvd Mountain Home ID 83647-3138 |
| Practice Telephone | 2085871500 |
| Practice Fax Number | 2085873180 |
| Mailing Telephone | 2085871500 |
| Mailing Fax Number | 2085873180 |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2008-02-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA-265 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902188832 | Delmar J Smith | Physician Assistant | 2900 Whipple Ave Ste 132, Redwood City, CA 94062 | 2011-09-16 |
| Street Address |
2000 AMERICAN LEGION BLVD |
| City | MOUNTAIN HOME |
| State | ID |
| Zip Code | 83647-3138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902809205 | Layne D. Roberts | Family Medicine | 2000 American Legion Blvd, Mountain Home, ID 83647-3138 | 2005-05-31 |
| 1679082945 | Ladd Family Pharmacy LLC | Pharmacy | 2000 American Legion Blvd, Mountain Home, ID 83647-3138 | 2017-09-29 |
| 1063578664 | Doctors Clinic of Elmore County Pllc | Physician Assistant | 2000 American Legion Blvd, Mountain Home, ID 83647-3138 | 2006-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528684370 | The Unruly Tongue Myofunctional Therapy LLC | Specialist | 1125 Nw Bluegrass Cir, Mountain Home, ID 83647 | 2020-06-17 |
| 1740767284 | Kelly Loy | Counselor | 210 North 3rd East, Mountain Home, ID 83647 | 2018-07-27 |
| 1891247912 | Daelene Sueann Tibbitts | Physical Therapy Assistant | 1665 E 5th N, Mountain Home, ID 83647 | 2016-10-25 |
| 1689065765 | Emma Orthel | Counselor | 2240 American Legion Blvd, Mountain Home, ID 83647 | 2015-02-11 |
| 1073692166 | Krzysztof Hendryk Ziola | Internal Medicine | 2280 American Legion Blvd., Mountain Home, ID 83647 | 2006-11-02 |
| 1952482440 | Michael Peter Koelsch | Internal Medicine | 805 North 6th East, Mountain Home, ID 83647 | 2006-10-18 |
| 1124113709 | Talmage W Delange | Counselor | 235 North 3rd East, Mountain Home, ID 83647 | 2006-10-03 |
| 1225044019 | Scott W Sessions | Physical Therapist | 245 N. 3rd, Mountain Home, ID 83647 | 2006-07-31 |
| 1750370730 | Kyle J Kenison | Optometrist | 855 West 6th South, Mountain Home, ID 83647 | 2005-10-21 |
| 1285628156 | Bruce Joseph Siedlecki | Obstetrics & Gynecology | Mtn.home Aif Force Base, Mdos, Mtn. Home, ID 83647 | 2005-09-07 |
| Find all providers in zip 83647 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871092189 | Joseph Wells Hoskin | Physician Assistant | 465 Mckenna Dr, Mountain Home, ID 83647-2143 | 2018-02-02 |
| 1932574381 | Kyle Hollenback | Physician Assistant | 2280 American Legion Blvd, Mountain Home, ID 83647-3142 | 2015-12-10 |
| 1144607268 | Hillary-paige Graves Potter | Physician Assistant | 17 Medical Plz, Mountain Home, AR 72653-2918 | 2015-04-27 |
| 1891197570 | Emily Moore | Physician Assistant | 465 Mckenna Dr, Mountain Home, ID 83647-2143 | 2014-09-24 |
| 1952738577 | Jonathan Grant Casto | Physician Assistant | 2280 American Legion Blvd., Mountain Home, ID 83647 | 2013-09-27 |
| 1922435544 | Ashley Genee Casto | Physician Assistant | 2280 American Legion Blvd, Mountain Home, ID 83647 | 2013-09-27 |
| 1982791927 | John Frank Testerman IIi | Physician Assistant | James H. Quillen/vamc, Corner of Sidney and Lamont (johnson City), Mountain Home, TN 37686 | 2006-10-10 |
| 1609807247 | Karen Miller Gunn | Physician Assistant | Lamont Street, Mountain Home, TN 37684 | 2006-07-05 |
| 1194765875 | Nancy Karen Bell | Physician Assistant | James H. Quillen Vamc, Dogwood Ave. 111c, Mountain Home, TN 37684 | 2006-06-08 |
| 1447215066 | James C Roelke | Physician Assistant | 628 Hospital Dr, Ground Floor, Suite A, Mountain Home, AR 72653-2953 | 2006-04-18 |
| Find all providers in MOUNTAIN HOME | ||||
| City | MOUNTAIN HOME |
| Zip Code | 83647 |
Please comment or provide details below to improve the information on MR. DELMAR WALLACE SMITH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.