Smith, Jerrold R

Smith, Jerrold R is an individual health care provider with primary practice located at 7910 E Washington St Suite 200, Indianapolis IN 46219-6803. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Smith, Jerrold R can be contacted via phone (317) 355-7171.

Contact Information

Primary practice address
7910 E Washington St Suite 200 Indianapolis IN 46219-6803
Phone: (317) 355-7171
Fax: (317) 355-9022
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 01021574A Indiana

Profile Details

NPI number 1578567202
LBN Legal business name Smith, Jerrold R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2005
Last updated Mar 9th, 2015 - about 9 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 1578567202 NPPES
Indiana Other 000000711341 ANTHEM
Indiana MEDICAID 100056310 ANTHEM

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