MR. WALLACE D SMITH (NPI# 1750376935) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750376935 |
| Entity Type | Individual |
| Full Name | MR. WALLACE D SMITH |
| Credential | MD |
| Practice Address |
620 Medical Dr Suite 340 Bountiful UT 84010-4908 |
| Practice Telephone | 8012992229 |
| Practice Fax Number | 8012992230 |
| Mailing Telephone | 8012992229 |
| Mailing Fax Number | 8012992230 |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2008-01-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 163585-1205 | UT | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871786830 | Wallace Harden Smith II | Psychiatry & Neurology | 3120 Cambridge Rd, Charlotte, NC 28209-1304 | 2007-08-23 |
| 1669813440 | Wallace Earl Smith | Counselor | 1801 Vicente St, San Francisco, CA 94116-2923 | 2013-07-09 |
| 1376800532 | Wallace Austin Smith | Dermatology | 383 S 300 E, St George, UT 84770-3620 | 2012-04-12 |
| 1134393010 | Wallace Kent Smith | Physical Therapy Assistant | 3703 W Lake Ave, Suite 200, Glenview, IL 60026-5823 | 2008-04-22 |
| Street Address |
620 MEDICAL DR SUITE 340 |
| City | BOUNTIFUL |
| State | UT |
| Zip Code | 84010-4908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942294475 | Molly Mears | Obstetrics & Gynecology | 620 Medical Dr, Suite 340, Bountiful, UT 84010-4908 | 2005-09-12 |
| 1083156384 | Melissa Yamashiro | Physician Assistant | 620 Medical Dr, Suite 205, Bountiful, UT 84010-5084 | 2016-11-17 |
| 1114217205 | Andrea P Edwards | Pediatrics | 620 Medical Dr, Suite 100, Bountiful, UT 84010-5084 | 2011-04-11 |
| 1861676165 | Lakeview Neurology PC | Neurological Surgery | 620 Medical Dr, Suite 150, Bountiful, UT 84010-5084 | 2007-12-21 |
| 1205977188 | Jonathan Milton Tew | Pediatrics | 620 Medical Dr, Suite 100, Bountiful, UT 84010-5084 | 2007-02-12 |
| 1598831604 | Laura Maudlyn Zaugg | Advanced Practice Midwife | 620 Medical Dr, Suite 340, Bountiful, UT 84010-5084 | 2006-11-28 |
| 1548360217 | Cope Family Medicine Lc | Family Medicine | 620 Medical Dr, Suite 150, Bountiful, UT 84010-5084 | 2006-09-23 |
| 1194825117 | Gina M Muscolino | Specialist | 620 Medical Dr, Suite 340, Bountiful, UT 84010-5084 | 2006-09-22 |
| 1831202118 | Lakeview Neurosurgery Clinic, LLC | Psychiatry & Neurology | 620 Medical Dr, Suite 300, Bountiful, UT 84010-5084 | 2006-08-17 |
| 1932112448 | Lakeview Hospital Physician Services LLC | Obstetrics & Gynecology | 620 Medical Dr, Suite 340, Bountiful, UT 84010-5084 | 2006-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225699192 | Jessyca K Willie | Behavior Technician | 415 S. Medical Drive Suite D101, Bountiful, UT 84010 | 2019-06-21 |
| 1336634344 | Shanna Joy Jaggers | Social Worker | 2333 S 200 E, Bountiful, UT 84010 | 2018-06-22 |
| 1447773171 | Live Life Alarms | Emergency Response System Companies | 640 South 500 West, Bountiful, UT 84010 | 2017-07-25 |
| 1902328842 | Hailey Embley | Behavior Technician | 415 Medical Drive D 101, Bountiful, UT 84010 | 2017-07-12 |
| 1508318031 | Beverly Nielsen | Psychologist | 1001 Lakeview Drive, Bountiful, UT 84010 | 2016-11-01 |
| 1295287720 | Samantha Oslund | Speech-Language Pathologist | 415 Medical Dr Ste B102, Bountiful, UT 84010 | 2016-11-01 |
| 1750748273 | Jeremy Clark Morris | Dentist | 59 W 1600 N, Suite 110, Bountiful, UT 84010 | 2016-01-28 |
| 1629464706 | Shane James | Speech-Language Pathologist | 425 Medical Dr Ste 122, Bountiful, UT 84010 | 2015-04-15 |
| 1891186102 | Kenton Francis | Social Worker | 1355 North Main Street #1, Bountiful, UT 84010 | 2015-02-09 |
| 1205233855 | Modern Dental Professionals - Utah, PC | Dentist | 24 S. 500 West, #a, Bountiful, UT 84010 | 2014-11-25 |
| Find all providers in zip 84010 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154589505 | Ryan Bruce Empey | Obstetrics & Gynecology | 620 Medical Dr Ste 340, Bountiful, UT 84010-5171 | 2008-06-01 |
| 1720252513 | Kandice Rose Nielson | Obstetrics & Gynecology | 620 Medical Dr., Ste 340, Bountiful, UT 84010 | 2008-04-14 |
| 1942294475 | Molly Mears | Obstetrics & Gynecology | 620 Medical Dr, Suite 340, Bountiful, UT 84010-4908 | 2005-09-12 |
| 1932112448 | Lakeview Hospital Physician Services LLC | Obstetrics & Gynecology | 620 Medical Dr, Suite 340, Bountiful, UT 84010-5084 | 2006-08-14 |
| 1639103252 | W. Gene Pead | Obstetrics & Gynecology | 390 N Main St, Bountiful, UT 84010-6046 | 2006-07-10 |
| 1760410203 | Mark A Stowers | Obstetrics & Gynecology | 390 N Main St, Bountiful, UT 84010-6046 | 2006-06-30 |
| 1134114473 | Nathan C Ward | Obstetrics & Gynecology | 620 Medical Dr, Suite 340, Bountiful, UT 84010-4908 | 2005-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144753013 | Jessica Kaplan | Obstetrics & Gynecology | University of Utah University Hospital, 50 N Medical Drive, Salt Lake City, UT 84132-0001 | 2017-04-07 |
| 1326571621 | Kylie Measom Soffe | Obstetrics & Gynecology | Ob Gyn Administration 30 N 1900 E Rm 2b200, Salt Lake City, UT 84132-2101 | 2017-04-04 |
| 1326492109 | Pennington Medical Center | Obstetrics & Gynecology | 3507 N University Ave Ste 175, Provo, UT 84604-6692 | 2016-04-19 |
| 1629430046 | Chadwick Miles Densley | Obstetrics & Gynecology | 12842 South 3600 West, Suite 200, Riverton, UT 84065 | 2016-03-24 |
| 1184090870 | Mountainstar Medical Group Timpanogos Specialty Care, LLC | Obstetrics & Gynecology | 1020 S 1100 W Ste B, Lehi, UT 84043-6041 | 2015-08-17 |
| 1639564016 | Kristen Hansord Lilja | Obstetrics & Gynecology | 82 S 1100 E Ste 305, Salt Lake City, UT 84102-4703 | 2015-04-01 |
| 1194119172 | Irina Cassimatis | Obstetrics & Gynecology | University of Utah Obgyn Dept, 30 N 1900 East. Room 2b200, Salt Lake City, UT 84132-0001 | 2015-03-26 |
| 1033509740 | Kathryn Fay | Obstetrics & Gynecology | 30 N 1900 E Rm 2a200, Salt Lake City, UT 84132-2209 | 2015-02-02 |
| 1932528676 | Aliye Runyan | Obstetrics & Gynecology | 30 North 1900 East 2a200, Dept of Obgyn, Salt Lake City, UT 84132 | 2014-04-09 |
| 1467870295 | Ashley Elizabeth Benson | Obstetrics & Gynecology | 30 N 9100 E, Room 2b200, Salt Lake City, UT 84132-0001 | 2014-03-29 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MR. WALLACE D 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.