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Individual

JASON ARTHUR SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
13601 PRESTON RD, SUITE 1000W, DALLAS, TX 75240-4911
(972) 715-5000
Mailing address
PO BOX 660857, DALLAS, TX 75266-0857
(972) 715-5000

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704257113
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1174884480
MI
01
4308721320
BCBS
MI
01
P01138205
RAILROAD MEDICARE
MI
Enumeration date
06/04/2012
Last updated
03/19/2013
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