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Individual

DR. JARVIS WILTON SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1234 HUFFMAN MILL RD, BURLINGTON, NC 27215-8700
(336) 538-1234
(336) 538-2390
Mailing address
PO BOX 1717, BURLINGTON, NC 27216-1717
(336) 538-1234
(336) 538-2390

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
29174
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8911807
NC
Enumeration date
07/20/2006
Last updated
01/30/2013
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