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Contact Information

MARK R SMITH, PHD
904 HWY 15 SOUTH FRONTAGE RD.
SUITE H
HUTCHINSON, MN55350
 Phone: 320-587-2939
 Fax: 320-864-1927
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for MARK R SMITH · (Male)

NPI # 1790779775
Status Active
Credentials PHD
Entity Individual
Enumeration date 09/07/2005
Last updated 10/30/2008 - About 18 years ago
Sole proprietor 1 Yes
Identifiers
  • MN License # LP2907
  • MN Medicaid 262248300
  • Other 0004049 AETNA
  • Other 112964 CHOICE PLUS
  • Other 24981 HEALTH PARTNERS
  • Other 990991000146 PREFERRED ONE/BHP
  • Other 030701079 PRIME WEST HEALTH SYST
  • Other 6120057 UNITED BEH HEALTH
  • IA Other 98520 BC
  • MN Other 53308SM BC
  • MN Other 115129 UCARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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