Individual
JERRY WAYNE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY, SUITE 570, MILWAUKEE, WI 53215-3669
(414) 385-8780
Mailing address
N106W7320 CHATHAM ST, CEDARBURG, WI 53012-3246
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10-023
WI
Other
Enumeration date
06/09/2006
Last updated
07/13/2026
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