Individual
MR. JEFFERY O SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
19 MYRTLE ST, MEDFORD, OR 97504-7337
(541) 773-3863
(541) 776-2892
Mailing address
19 MYRTLE ST, MEDFORD, OR 97504-7337
(541) 773-3863
(541) 776-2892
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
13401
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07920077
—
CO
Enumeration date
06/06/2006
Last updated
04/16/2014
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