Individual
KENNETH SMITH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
123 WILLOW OAK LANE, MULLICA HILL, NJ 08062
(856) 237-4126
(856) 417-3089
Mailing address
123 WILLOW OAK LANE, MULLICA HILL, NJ 08062
(856) 220-0630
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MB06618700
NJ
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MB66187
NJ
Other
Enumeration date
05/10/2006
Last updated
10/02/2018
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