Individual
JACQUELYN RAE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1746 COLE BLVD STE 150, LAKEWOOD, CO 80401
(303) 914-8800
(303) 716-3777
Mailing address
816 W CANNON ST, FORT WORTH, TX 76104-3194
(817) 321-0404
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
DR.0056367
CO
2085R0202X
Diagnostic Radiology Physician
Primary
DR.0056367
CO
2085R0202X
Diagnostic Radiology Physician
P9572
TX
Other
Enumeration date
04/06/2011
Last updated
12/29/2022
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