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Individual

DONALD RAY SMITH JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
2533 CUMBERLAND TRL, BALCH SPRINGS, TX 75181-2164
(850) 393-1181
Mailing address
2533 CUMBERLAND TRL, BALCH SPRINGS, TX 75181-2164

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
332886
LA
363A00000X
Physician Assistant
4212-23
WI
363A00000X
Physician Assistant
Primary
PA-2644
ID
363A00000X
Physician Assistant
PA08849
TX
363A00000X
Physician Assistant
PA9105176
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001640200
FL
01
CR580Z
MEDICARE
FL
Enumeration date
09/23/2009
Last updated
11/22/2023
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