| Brennen D Smith, DO | |
|
2400 St Francis Dr, Breckenridge, MN 56520-1025 | |
| (218) 643-3000 | |
| (218) 643-0850 |
| Full Name | Brennen D Smith |
|---|---|
| Gender | Male |
| Speciality | Orthopaedic Surgery - Orthopaedic Surgery Of The Spine |
| Location | 2400 St Francis Dr, Breckenridge, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376753277 | NPI | - | NPPES |
| 1471472 | Medicaid | ND | |
| 3158630 | Medicaid | OH | |
| 000000480404 | Other | OH | OH MEDICAID UNISON |
| 3810022462 | Medicaid | WV |
| Entity Name | Fairview Health Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013994359 PECOS PAC ID: 1951213057 Enrollment ID: O20031105000461 |
| Entity Name | Fairview Clinics |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346432218 PECOS PAC ID: 7113830142 Enrollment ID: O20031106000516 |
| Entity Name | St. Joseph's Area Health Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023086055 PECOS PAC ID: 0345146510 Enrollment ID: O20031209000521 |
| Entity Name | Riverview Healthcare Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811918436 PECOS PAC ID: 7810806718 Enrollment ID: O20040128000040 |
| Entity Name | St Francis Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891954574 PECOS PAC ID: 8123937992 Enrollment ID: O20040429000995 |
| Entity Name | Glacial Ridge Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1255348223 PECOS PAC ID: 5294789194 Enrollment ID: O20050719000315 |
| Entity Name | Riverview Healthcare Association |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1487944898 PECOS PAC ID: 7810806718 Enrollment ID: O20060505000925 |
| Entity Name | Glacial Ridge Hospital District |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1538178520 PECOS PAC ID: 5294789194 Enrollment ID: O20061104000464 |
| Entity Name | St. Joseph's Area Health Services |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1023086055 PECOS PAC ID: 0345146510 Enrollment ID: O20061104000649 |
| Entity Name | St Francis Medical Center |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1639162381 PECOS PAC ID: 8123937992 Enrollment ID: O20080303000129 |
| Entity Name | Fairview Express Care |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053952606 PECOS PAC ID: 3375645179 Enrollment ID: O20081028000548 |
| Mailing Address | Practice Location Address |
|---|---|
| Brennen D Smith, DO 4784 Amber Valley Pkwy S, Chi Provider Enrollment - Fargo Divison, Fargo, ND 58104-8614 Ph: (701) 237-8072 | Brennen D Smith, DO 2400 St Francis Dr, Breckenridge, MN 56520-1025 Ph: (218) 643-3000 |