Smith, Jerry M
Smith, Jerry M is an individual health care provider with primary practice located at 4643 Dock Rd Bldg 524, Port Hueneme CA 93043-4321. He recently has only one registered license in Other Service Providers / Independent Duty Corpsman, which is considered as his primary health care specialty. Smith, Jerry M can be contacted via phone (805) 982-2411.Contact Information
Primary practice address
4643 Dock Rd Bldg 524
Port Hueneme CA 93043-4321
Phone: (805) 982-2411
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Independent Duty Corpsman | 1710I1002X |
Profile Details
| NPI number | 1659460590 |
|---|---|
| LBN Legal business name | Smith, Jerry M |
| Credentials | IDC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 11th, 2006 |
| 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.
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