Provider Demographics
NPI:1831197979
Name:SMITH, JEFFREY F (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:F
Last Name:SMITH
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 1:315 E WARWICK DR
Mailing Address - Street 2:SUITE #3
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-1083
Mailing Address - Country:US
Mailing Address - Phone:989-463-6699
Mailing Address - Fax:989-466-2574
Practice Address - Street 1:315 E WARWICK DR
Practice Address - Street 2:SUITE #3
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1083
Practice Address - Country:US
Practice Address - Phone:989-463-6699
Practice Address - Fax:989-466-2574
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301052770208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4354196Medicaid
MIN38380001Medicare ID - Type Unspecified
MI4354196Medicaid