Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 1894 | TX |
NPI | 1013141209 |
---|---|
Provider Name | Dr. Jason Todd Smith |
First Address | Newport, AR 72112-3500 |
Second Address | Newport, AR 72112-3500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2009 |
Last Update Date | 20/01/2011 |