Organization
JACK D. SMITH, MD, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK D SMITH MD (PRESIDENT)
(724) 834-4448
Entity
Organization
Contact information
Practice address
133 DONOHOE RD, GREENSBURG, PA 15601-6986
(724) 834-4448
(724) 834-8563
Mailing address
133 DONOHOE RD, GREENSBURG, PA 15601-6986
(724) 834-4448
(724) 834-8563
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD015396E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0734802
UNITED MINE WORKERS
PA
01
—
103789
UPMC
PA
01
—
1948968
HIGHMARK
PA
01
—
3309195
AETNA
PA
Enumeration date
03/02/2007
Last updated
04/20/2008
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