Provider Demographics
NPI:1073738902
Name:SMITH, DANNY PAUL (DO)
Entity Type:Individual
Prefix:DR
First Name:DANNY
Middle Name:PAUL
Last Name:SMITH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:DANNY
Other - Middle Name:PAUL
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:3313 SW 29TH ST
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-8878
Mailing Address - Country:US
Mailing Address - Phone:515-965-9775
Mailing Address - Fax:
Practice Address - Street 1:7105 NW 70TH AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-1824
Practice Address - Country:US
Practice Address - Phone:515-252-4317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine