Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD013483E | PA |
Y | 208600000X | Surgeon | MD013483E | PA |
N | 2086S0102X | Surgical Critical Care | MD013483E | PA |
NPI | 1194782003 |
---|---|
Provider Name | J Stanley Smith |
First Address | Hershey, PA 17033-0854 |
Second Address | Hershey, PA 17033-2360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 29/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0005920820001 | (05) | PA |
C31523 | (02) |