Individual
DR. JONATHAN TYLER SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4755 PASTURE RD BLDG 299, FALLON, NV 89496-5000
(775) 426-3128
Mailing address
4755 PASTURE RD BLDG 299, FALLON, NV 89496-5000
(775) 426-3128
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
0101283882
VA
208D00000X
General Practice Physician
Primary
0101283882
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
KY
Other
Enumeration date
04/27/2021
Last updated
08/11/2025
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