Individual
JEROME CHARLES SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
651 1ST ST W, SUITE H, SONOMA, CA 95476-7045
(707) 938-3870
(707) 938-3895
Mailing address
651 1ST ST W, SUITE H, SONOMA, CA 95476-7045
(707) 938-3870
(707) 938-3895
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A66490
CA
208000000X
Pediatrics Physician
ME83173
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
262135500
—
FL
05
—
FHC53855F
—
CA
Enumeration date
02/08/2006
Last updated
10/06/2011
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