Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | TRAINING LICPENDING | CO |
NPI | 1063701431 |
---|---|
Provider Name | Jason E. Smith |
First Address | Helena, MT 59604-6369 |
Second Address | Greeley, CO 80634-6070 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2011 |
Last Update Date | 25/02/2016 |