Direct Surgical Assist PA

NPI #1194017954 in Star, Idaho

Provider Information

NPI Number: 1194017954
Entity Type: Organization
Organization Name: Direct Surgical Assist PA
Primary Specialty: Physician Assistant
Enumeration Date: May 11, 2011
Last Updated: May 11, 2011

Practice Location

Address: 695 N ASPEN LAKES WAY
City: Star
State: Idaho
ZIP Code: 83669-5674
Phone: (208) 989-0598

Authorized Official

Name: MR. JEFFREY DALE SMITH, PA-C
Title: PRESIDENT
Phone: (208) 989-0598

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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