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BRODI SMITH, D.O., PLLC

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Company Details

Name: BRODI SMITH, D.O., PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 06 Feb 2018 (7 years ago)
Financial Date End: 28 Feb 2026
Entity Number: 590006
Place of Formation: IDAHO
File Number: 590006
ZIP code: 83404
County: Bonneville County
Principal Address: 2805 VALENCIA DR IDAHO FALLS, ID 83404
Mailing Address: 2805 VALENCIA DR IDAHO FALLS, ID 83404-7597

Agent

Name Role Address
BRODI SMITH Agent 2805 VALENCIA DR, IDAHO FALLS, ID 83404

Member

Name Role Address Appointed On
Brodi Smith Member 2805 VALENCIA DRIVE, IDAHO FALLS, ID 83404 2021-02-11

National Provider Identifier

NPI Number:
1659863207
Certification Date:
2024-08-01

Authorized Person:

Name:
BRODI SMITH
Role:
DO
Phone:

Taxonomy:

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

Contacts:

Fax:
2085256151

Filing

Filing Name Filing Number Filing date
Annual Report 0006045522 2025-01-03
Annual Report 0005599467 2024-02-12
Annual Report 0005059529 2023-01-09
Annual Report 0004556144 2022-01-05
Annual Report 0004172103 2021-02-11

Paycheck Protection Program

Jobs Reported:
1
Initial Approval Amount:
$20,832
Date Approved:
2020-04-15
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$20,832
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$21,029.33
Servicing Lender:
U.S. Bank, National Association
Use of Proceeds:
Payroll: $20,832

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Date of last update: 04 Jul 2025

Sources: Idaho Secretary of State