Smith, Jerry
Smith, Jerry is an individual health care provider with primary practice located at 1630 E Herndon Ave , Fresno CA 93720-3305. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Smith, Jerry can be contacted via phone (559) 256-5200.Contact Information
Primary practice address
1630 E Herndon Ave
Fresno CA 93720-3305
Phone: (559) 256-5200
Fax: (559) 256-5376
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | C51861 | California |
Profile Details
| NPI number | 1780667667 |
|---|---|
| LBN Legal business name | Smith, Jerry |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 23rd, 2005 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1780667667 | NPPES |
| California | Other | 0195819 | STATE OF WASHINGTON |
| California | Other | P00220553 | STATE OF WASHINGTON |
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