Individual
JOHN JOSEPH SMITH III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2010 BALDWIN LN, WINSTON SALEM, NC 27103-5846
(336) 564-4430
(336) 277-1718
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 564-4430
(336) 277-1718
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
2006-01208
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10385121
—
VA
01
—
143A1
BCBS
—
01
—
191377
MEDCOST
—
05
—
3810007318
—
WV
01
—
4397049
AETNA
—
05
—
5905795
—
NC
05
—
6193161
—
MA
01
—
808464
PARTNERS
—
01
—
P00378870
RR MEDICARE
—
05
—
Q0120D
—
SC
Enumeration date
10/04/2005
Last updated
07/12/2023
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