Phonso Smith

NPI 1366824864 · on the registry since 2015 · sole proprietor

Practice

Address: 1300 S Green Bay Rd
Mount Pleasant, WI 53406
Phone: (262) 898-3930
Fax: (262) 898-3933
Organisation at this address: Badger Care Llc
Forefront Dermatology, S.C.
Advantage Pt & Sports Rehab Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 8

Registry record

Primary taxonomy: 225100000X
225100000X
Licence states on file: WI
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2015-06-22

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin