Individual
JASON BYRNE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2516
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0643
ND
363AM0700X
Medical Physician Assistant
PAC0643
ND
Other
Enumeration date
07/27/2016
Last updated
12/15/2025
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