Smith, Judson P

Smith, Judson P is an individual health care provider with primary practice located at 417 W Magnolia Ave , Fort Worth TX 76104. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Smith, Judson P can be contacted via phone (817) 338-4081.

Contact Information

Primary practice address
417 W Magnolia Ave Fort Worth TX 76104
Phone: (817) 338-4081
Fax: (817) 870-1612
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X D9667 Texas

Profile Details

NPI number 1861456584
LBN Legal business name Smith, Judson P
Credentials MD PA
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 12th, 2006
Last updated Jul 20th, 2010 - about 16 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 1861456584 NPPES
Texas Other 1215156120 BLUE CROSS BLUE SHIELD
Texas MEDICAID 1493934-01 BLUE CROSS BLUE SHIELD
Texas Other 0004246771 BLUE CROSS BLUE SHIELD
Texas Other 180000666 BLUE CROSS BLUE SHIELD

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