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BRAD D. SMITH, D.O., P.A.

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Company Details

Name: BRAD D. SMITH, D.O., P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 17 Nov 2005 (20 years ago)
Financial Date End: 30 Nov 2020
Date dissolved: 04 Feb 2021
Entity Number: 496020
Place of Formation: IDAHO
File Number: 496020
ZIP code: 83404
County: Bonneville County
Mailing Address: 2805 VALENCIA DR IDAHO FALLS, ID 83404-7597

Agent

Name Role Address
Brad D Smith Agent 2805 VALENCIA DR, IDAHO FALLS, ID 83404

National Provider Identifier

NPI Number:
1336246701

Authorized Person:

Name:
BRAD D SMITH
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
208600000X - Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
2085256151
Fax:
2082526151

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0004161986 2021-02-04
Application for Reinstatement 0003841684 2020-04-09
Dissolution/Revocation - Administrative 0003774046 2020-02-06
Annual Report 0003369542 2018-12-11
Annual Report 0003050442 2017-10-05

Paycheck Protection Program

Jobs Reported:
1
Initial Approval Amount:
$18,700
Date Approved:
2020-04-15
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$18,700
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$18,839.87
Servicing Lender:
Zions Bank, A Division of
Use of Proceeds:
Payroll: $18,700

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Date of last update: 02 Jul 2025

Sources: Idaho Secretary of State