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Individual
JIMMY J SMITH
Active
Individual
JIMMY J SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
A5449
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0070748
—
IA
01
—
02918
WELLMARK BC BS
IA
05
—
1164571451
—
IA
01
—
252196
MIDLANDS CHOICE
IA
01
—
70908
WELLMARK BCBS
IA
Enumeration date
01/09/2007
Last updated
09/16/2013
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