Smith, Roosevelt J
Smith, Roosevelt J is an individual health care provider with primary practice located at 4518-A West Market St , Greensboro NC 27407. He recently has only one registered license in Chiropractic Providers / Sports Physician, which is considered as his primary health care specialty. Smith, Roosevelt J can be contacted via phone (336) 235-4022.Contact Information
Primary practice address
4518-A West Market St
Greensboro NC 27407
Phone: (336) 235-4022
Fax: (336) 235-4023
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Sports Physician | 111NS0005X | 2930 | North Carolina |
Profile Details
| NPI number | 1235235680 |
|---|---|
| LBN Legal business name | Smith, Roosevelt J |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 15th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235235680 | NPPES |
| North Carolina | MEDICAID | 89085AM |
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