Individual
DR. ALTON J. SMALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
12140 NEW YORK RANCH ROAD, JACKSON RANCHERIA HEALTH COMPLEX, JACKSON, CA 95642-9344
(209) 257-2400
(209) 257-2403
Mailing address
12140 NEW YORK RANCH ROAD, JACKSON RANCHERIA HEALTH COMPLEX, JACKSON, CA 95642-9344
(209) 257-2400
(209) 257-2403
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E2150
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E21500
—
CA
01
—
48006076
RR INDIVIDUAL PROV. #
CA
01
—
P00452685
NEW RR PROVIDER #
CA
Enumeration date
07/19/2005
Last updated
10/13/2021
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