# DR. JASON LARRY SMITH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1558391169
- **Gender:** Man
- **Credential:** DC, MS, DACNB

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 369867-1202 | UT | Yes |

## Other

- **Enumeration date:** 07/03/2006
- **Last updated:** 12/06/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 350055669 | RAILROAD MEDICARE NUMBER | UT |