person
Roosevelt Smith JR., PAC,ATR
Medical Physician Assistant in Winona, Minnesota
NPI 1003836701

Roosevelt Smith JR. is a Medical Physician Assistant based in Winona, MN and is specialized in Medical. Roosevelt Smith JR. practices in Winona, MN and has the professional credentials of PAC,ATR. The NPI Number for Roosevelt Smith JR. is 1003836701 and holds a License No. 9155 (Minnesota).

The current practice location address for Roosevelt Smith JR. is 62 E 3Rd St, Winona, MN and can be reached out via phone at 507-474-4770 and via fax at 507-474-4774. You can also correspond with Roosevelt Smith JR. through the mailing address at 62 E 3RD ST, WINONA, MN - 55987-3481 (mailing address contact number: 507-474-4770).

Location: 62 E 3Rd St, Winona, MN, 55987-3481
person
Provider Profile Details
NPI Number
1003836701
Provider Name
Roosevelt Smith JR.
Credential
PAC,ATR
Provider Entity Type
Individual
Gender
Male
Address
62 E 3Rd St, Winona, MN, 55987-3481
Phone Number
507-474-4770
Fax Number
507-474-4774
Provider Enumeration Date
07/19/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0121686 01 MN MEDICA
679G2SM 01 MN BCBS MN
HP32318 01 MN HEALTH PARTNERS
institution
Provider Business Practice Location Address Details
Address
62 E 3Rd St
City
State
Zip
55987-3481
Phone Number
507-474-4770
Fax Number
507-474-4774
person
Provider Business Mailing Address Details
Address
62 E 3Rd St
City
State
Zip
55987-3481
Phone Number
507-474-4770
Fax Number
507-474-4774
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
9155 (Minnesota)
Definition
Definition to come...
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