Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 01061841A | IN |
NPI | 1679530851 |
---|---|
Provider Name | Dr. Jonathan Patrick Smerek |
First Address | Indianapolis, IN 46280-1393 |
Second Address | Indianapolis, IN 46280-1393 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2006 |
Last Update Date | 12/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200887380 | (05) | IN |
I73431 | (02) | IN |
P00418220 | RR MEDICARE PIN (01) | IN |