Individual
MR. JOHN GERARD SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
185 QUEEN CITY AVE, MANCHESTER, NH 03101-7121
(603) 627-1102
(603) 647-5524
Mailing address
185 QUEEN CITY AVE, MANCHESTER, NH 03101-7121
(603) 627-1102
(603) 647-5524
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0571
NH
363AM0700X
Medical Physician Assistant
0157
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3077022
—
NH
05
—
320420099
—
ME
01
—
P00331200
RAILROAD MEDICARE
—
01
—
P00394782
RAILROAD
NH
Enumeration date
06/02/2006
Last updated
03/04/2024
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