Smith, Gregory N

Smith, Gregory N is an individual health care provider with primary practice located at 1250 S 18Th St Suite 204, Fernandina Beach FL 32034-1902. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Smith, Gregory N can be contacted via phone (904) 261-8787.

Contact Information

Primary practice address
1250 S 18Th St Suite 204 Fernandina Beach FL 32034-1902
Phone: (904) 261-8787
Fax: (904) 261-9353
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X ME66525 Florida

Profile Details

NPI number 1508868464
LBN Legal business name Smith, Gregory N
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2005
Last updated Nov 16th, 2020 - about 5 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 1508868464 NPPES
Florida Other 200029264 RAILROAD MEDICARE
Florida MEDICAID 253374000 RAILROAD MEDICARE

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