Individual
DR. JEFFREY R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2350 N ROCKTON AVE, ROCKFORD, IL 61103-3600
(815) 971-2200
(815) 971-9097
Mailing address
2350 N ROCKTON AVE, ROCKFORD, IL 61103-3600
(815) 971-2200
(815) 971-9097
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036078927
IL
207RC0000X
Cardiovascular Disease Physician
Primary
036-078927
IL
207RC0001X
Clinical Cardiac Electrophysiology Physician
036078927
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036078927
—
IL
05
—
1346200938
—
WI
Enumeration date
03/27/2006
Last updated
09/03/2020
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