Individual
JEREMY TAYLOR SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1153 CENTRE STREET, SUITE 56, FAULKNER HOSPITAL, JAMAICA PLAIN, MA 02130
(617) 983-7295
Mailing address
1153 CENTRE STREET, SUITE 56, FAULKNER HOSPITAL, JAMAICA PLAIN, MA 02130
(617) 983-7295
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
228179
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
228179
LIMITED LICENSE
MA
01
—
246799
MA STATE LICENSE
MA
Enumeration date
12/15/2006
Last updated
01/28/2014
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