Individual
DR. JEFFREY DANIEL SMITHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2605 E CREEKS EDGE DR, BLOOMINGTON, IN 47401-8368
(812) 333-2663
(812) 355-2310
Mailing address
2605 E CREEKS EDGE DR, BLOOMINGTON, IN 47401-8368
(812) 333-2663
(812) 349-9206
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01075102A
IN
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
01075102A
IN
208000000X
Pediatrics Physician
01075102A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201291450
—
IN
Enumeration date
05/01/2007
Last updated
03/16/2021
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