Smith, Jeffery O

Smith, Jeffery O is an individual health care provider with primary practice located at 19 Myrtle St , Medford OR 97504-7337. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Smith, Jeffery O can be contacted via phone (541) 773-3863.

Contact Information

Primary practice address
19 Myrtle St Medford OR 97504-7337
Fax: (541) 776-2892
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 13401 Colorado

Profile Details

NPI number 1871532689
LBN Legal business name Smith, Jeffery O
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated Apr 16th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871532689 NPPES
Colorado MEDICAID 07920077

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