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Individual

GREG D SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APNP

Contact information

Practice address
555 BLACK OAK DR, MEDFORD, OR 97504
(541) 789-8176
Mailing address
2620 E BARNETT RD STE H, MEDFORD, OR 97504-8383
(541) 789-8176
(541) 789-2558

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201902885NP-PP
OR
363LG0600X
Gerontology Nurse Practitioner
7702-33
WI

Other

Enumeration date
06/14/2017
Last updated
10/13/2021
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