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Individual

JOHN M SMALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0925
(813) 978-9700
(813) 972-5055
Mailing address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0925
(813) 978-9700
(813) 972-5055

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME0070409
FL
207XS0117X
Orthopaedic Surgery of the Spine Physician
ME0070409
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200028917
MEDICARE RAILROAD
FL
01
212065
AVMED
FL
05
250385900
FL
01
31905
BC/BS
FL
01
5054177
AETNA
FL
01
5306966
CIGNA
FL
Enumeration date
07/01/2005
Last updated
10/13/2017
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