Provider Demographics
NPI:1306147681
Name:SMATHERS, JOSEPH CHARLES (DC, DO)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CHARLES
Last Name:SMATHERS
Suffix:
Gender:M
Credentials:DC, DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374TH MEDICAL GROUP
Mailing Address - Street 2:UNIT 5071
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96328-5071
Mailing Address - Country:US
Mailing Address - Phone:315-225-3575
Mailing Address - Fax:
Practice Address - Street 1:374TH MEDICAL GROUP
Practice Address - Street 2:UNIT 5071
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96328-5071
Practice Address - Country:US
Practice Address - Phone:315-225-3575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11590111N00000X
390200000X
KY05229207XX0005X
CA20A17503207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No111N00000XChiropractic ProvidersChiropractor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery