Organization
JONATHAN SMITH, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN K SMITH MD (PRESIDENT)
(251) 580-4243
Entity
Organization
Contact information
Practice address
2002 HAND AVE, BAY MINETTE, AL 36507
(251) 580-4243
(251) 580-4189
Mailing address
PO BOX 1627, BAY MINETTE, AL 36507-1627
(251) 580-4243
(251) 580-4189
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
22065
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113549
—
AL
01
—
51049680
BCBS
AL
Enumeration date
08/01/2009
Last updated
11/08/2010
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