Provider Demographics
NPI:1356780076
Name:SMITH, CHRISTOPHER BRYANT (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:BRYANT
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 HOMESTEAD RD STE 30
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-4874
Mailing Address - Country:US
Mailing Address - Phone:435-615-0435
Mailing Address - Fax:435-604-0261
Practice Address - Street 1:2700 HOMESTEAD RD
Practice Address - Street 2:STE 30
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-4874
Practice Address - Country:US
Practice Address - Phone:435-658-3090
Practice Address - Fax:435-604-0261
Is Sole Proprietor?:No
Enumeration Date:2013-06-15
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014016539207W00000X
UT10244495-1205207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology