Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | K3476 | TX |
NPI | 1295749877 |
---|---|
Provider Name | Jeffrey Scott Smith |
First Address | Granbury, TX 76048-1232 |
Second Address | Granbury, TX 76048-1232 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 11/11/2020 |