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:
Health care specialties
| Specialty | Code | License # | 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 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871558114 | NPPES |
| Florida | Other | 46719 | BCBS |
| Florida | MEDICAID | 256488200 | BCBS |
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