Provider Demographics
NPI:1487145751
Name:SMEDLEY, JERRAD BARTON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JERRAD
Middle Name:BARTON
Last Name:SMEDLEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5353 YELLOWSTONE RD STE 211
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-4178
Mailing Address - Country:US
Mailing Address - Phone:307-433-3709
Mailing Address - Fax:
Practice Address - Street 1:5353 YELLOWSTONE RD STE 211
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-4178
Practice Address - Country:US
Practice Address - Phone:307-433-3709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5646309-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist