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Individual

GEORGE JAY WALKER SMITH SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
160 ALLEN ST, RUTLAND REGIONAL MEDICAL CENTER - PATHOLOGY LAB, RUTLAND, VT 05701-4560
(802) 747-1789
(802) 747-6525
Mailing address
160 ALLEN ST, RUTLAND REGIONAL MEDICAL CENTER - PATHOLOGY LAB, RUTLAND, VT 05701-4560
(802) 747-1789
(802) 747-6525

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
042-0009681
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0048280
BLUE SHIELD VT
VT
05
OVN2023
VT
Enumeration date
01/24/2007
Last updated
04/05/2026
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