Individual
DR. JON B SMUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2310 CALIFORNIA RD STE A, ELKHART, IN 46514-1228
(574) 264-0791
(574) 262-5183
Mailing address
2310 CALIFORNIA RD STE A, ELKHART, IN 46514-1228
(574) 264-0791
(574) 262-9650
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
10167873A
IN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
01067873A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200981040
—
IN
Enumeration date
06/06/2007
Last updated
03/20/2018
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