Individual
DUSTIN K SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 542-7762
Mailing address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02003741A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
06/23/2008
Last updated
08/17/2021
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