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Individual

DR. JEFFREY ALAN SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
3455 POLO RD, SUITE 106, WINSTON SALEM, NC 27106-4828
(336) 354-1171
(336) 768-1860
Mailing address
3455 POLO RD, SUITE 106, WINSTON SALEM, NC 27106-4828
(336) 354-1171
(336) 768-1860

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1486
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0444F
BCBS
NC
Enumeration date
07/11/2006
Last updated
07/08/2007
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