Organization
ARNOLD GRAHAM SMITH, MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANNON GOOSSEN (ADMIN/VP)
(904) 391-6862
Entity
Organization
Contact information
Practice address
9191 R G SKINNER PKWY, SUITE 103, JACKSONVILLE, FL 32256-9655
(904) 391-6862
(904) 391-1005
Mailing address
9191 R G SKINNER PKWY, SUITE 103, JACKSONVILLE, FL 32256-9655
(904) 391-6862
(904) 391-1005
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0039103
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15651
BCBS PROVIDER NUMBER
—
Enumeration date
03/15/2013
Last updated
05/06/2013
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