DR. Glen B Smith, M.D.

NPI #1326031105 in Bloomington, Illinois

Provider Information

NPI Number: 1326031105
Entity Type: Individual
Name: DR. Glen B Smith, M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Thoracic Surgery (Cardiothoracic Vascular Surgery)
Credential: M.D.
Enumeration Date: Aug 26, 2005
Last Updated: Nov 13, 2012

Practice Location

Address: 1505 EASTLAND DR
Address 2: SUITE 210
City: Bloomington
State: Illinois
ZIP Code: 61701-7906
Phone: (309) 662-5506

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery)	208G00000X	Primary

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Organizations

Provider Name	Specialty	City
Illinois Cardiovascular & Thoracic Surgery, Ltd	Thoracic Surgery (Cardiothoracic Vascular Surgery)	Bloomington	AI Deep Dive

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