Provider Demographics
NPI:1265466643
Name:CHERNI-SMITH, RITA J (MD)
Entity type:Individual
Prefix:DR
First Name:RITA
Middle Name:J
Last Name:CHERNI-SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 787
Mailing Address - Street 2:1039 WYOMING HIGHWAY 345
Mailing Address - City:RANCHESTER
Mailing Address - State:WY
Mailing Address - Zip Code:82839-0787
Mailing Address - Country:US
Mailing Address - Phone:307-655-2317
Mailing Address - Fax:
Practice Address - Street 1:1401 W 5TH ST
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-2705
Practice Address - Country:US
Practice Address - Phone:307-675-2667
Practice Address - Fax:307-675-2668
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9440207R00000X
ORMD14009207R00000X
WY5870A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine