Provider Demographics
NPI:1427046820
Name:SMITHSON, J DANIEL (MD)
Entity type:Individual
Prefix:MR
First Name:J
Middle Name:DANIEL
Last Name:SMITHSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 17TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:BAKER CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97814-1300
Mailing Address - Country:US
Mailing Address - Phone:541-523-1001
Mailing Address - Fax:541-523-1152
Practice Address - Street 1:3950 17TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:BAKER CITY
Practice Address - State:OR
Practice Address - Zip Code:97814-1300
Practice Address - Country:US
Practice Address - Phone:541-523-1001
Practice Address - Fax:541-523-1152
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2012-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD22676207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine