Individual
JEVIN ALLEN SMITH
Active
Individual
JEVIN ALLEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
E-5962
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5H894
BCBS
—
01
—
E-5962
STATE MEDICAL LICENSE
AR
Enumeration date
04/25/2007
Last updated
12/04/2009
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