Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | ME0039103 | FL |
NPI | 1194805085 |
---|---|
Provider Name | Dr. Arnold Graham Smith |
First Address | Jacksonville, FL 32256-9655 |
Second Address | Jacksonville, FL 32256-9655 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 12/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010001690 | RAILROAD MEDICARE (01) | FL |
15651 | BCBS PROVIDER NUMBER (01) | FL |
D52683 | (02) | FL |