Smith, Mark Anthony

Smith, Mark Anthony is an individual health care provider with primary practice located at 13460 Beach Blvd Ste 1 , Jacksonville FL 32224-0301. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Smith, Mark Anthony can be contacted via phone (904) 854-1700.

Contact Information

Primary practice address
13460 Beach Blvd Ste 1 Jacksonville FL 32224-0301
Phone: (904) 854-1700
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X ME77870 Florida
Allopathic & Osteopathic Physicians / General Practice 208D00000X ME77870 Florida

Profile Details

NPI number 1871558114
LBN Legal business name Smith, Mark Anthony
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2006
Last updated Feb 9th, 2022 - about 3 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 1871558114 NPPES
Florida Other 46719 BCBS
Florida MEDICAID 256488200 BCBS

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