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Individual
DR. JONATHAN MARK SMITH
Active
Individual
DR. JONATHAN MARK SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000685
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100359030
—
IN
01
—
480024190
RAIL ROAD
IN
Enumeration date
06/15/2006
Last updated
06/30/2008
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