Individual
DR. JONATHAN MARK SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
145 S 2ND ST, DECATUR, IN 46733-1664
(260) 724-7179
(260) 724-8532
Mailing address
145 S 2ND ST, PO BOX 575, DECATUR, IN 46733-1664
(260) 724-7179
(260) 724-8532
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000685
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100359030
—
IN
01
—
480024190
RAIL ROAD
IN
Enumeration date
06/15/2006
Last updated
06/30/2008
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