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Individual

JEFFERY DEWARD SMITH

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
4540 E BASELINE RD, SUITE#114, MESA, AZ 85206-4613
(480) 633-0294
(480) 633-0604
Mailing address
PO BOX 682, GILBERT, AZ 85299-0682
(480) 633-0294
(480) 633-0604

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2409
AZ

Other

Enumeration date
12/29/2005
Last updated
03/07/2023
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