Individual
DR. MARK ANTHONY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13460 BEACH BLVD STE 1, JACKSONVILLE, FL 32224-0301
(904) 854-1700
Mailing address
2925 LEON RD, JACKSONVILLE, FL 32246-3664
(904) 536-6755
(904) 646-0278
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
ME77870
FL
208D00000X
General Practice Physician
Primary
ME77870
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
256488200
—
FL
01
—
46719
BCBS
FL
Enumeration date
04/19/2006
Last updated
02/09/2022
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