Individual
MR. JOE SMITH JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
2817 REILLY ROAD MCXC COD CREDENTIALS, WOMACK ARMY MEDICAL CENTER, FORT BRAGG, NC 28310
(910) 907-8922
(910) 907-6069
Mailing address
2817 REILLY ROAD MCXC COD CREDENTIALS, WOMACK ARMY MEDICAL CENTER, FORT BRAGG, NC 28310
(910) 907-8922
(910) 907-6069
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1000190
NC
Other
Enumeration date
02/13/2006
Last updated
07/08/2007
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