Individual
JEDEDIAH GEORGE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
549 FAIR ST., BLOOMSBURG, PA 17815-6151
(570) 387-2111
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA056709
PA
363AS0400X
Surgical Physician Assistant
—
PA
Other
Enumeration date
01/08/2014
Last updated
07/21/2022
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