Individual
JEFFREY A SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-1000
Mailing address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-1000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
43273
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104891209
—
WI
01
—
43273-20
WI LICENSE
WI
Enumeration date
02/22/2006
Last updated
12/28/2021
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