Provider Demographics
NPI:1649387853
Name:SMITH, JAMES R (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:SMITH
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1630 CHIPPEWA DR
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-9503
Mailing Address - Country:US
Mailing Address - Phone:715-361-5480
Mailing Address - Fax:715-361-5499
Practice Address - Street 1:1630 CHIPPEWA DR
Practice Address - Street 2:
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-9503
Practice Address - Country:US
Practice Address - Phone:715-361-5480
Practice Address - Fax:715-361-5499
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2013-12-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI40924207Q00000X
MI5101013329207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine