Individual
DR. GREGORY N SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1250 S 18TH ST, SUITE 204, FERNANDINA BEACH, FL 32034-1902
(904) 261-8787
(904) 261-9353
Mailing address
1325 SAN MARCO BLVD, SUITE 200, JACKSONVILLE, FL 32207-8568
(904) 346-3465
(904) 261-9353
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
ME66525
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200029264
RAILROAD MEDICARE
FL
05
—
253374000
—
FL
Enumeration date
08/11/2005
Last updated
11/16/2020
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