Individual
JARED M SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 JOHN ROEMMELT DR STE 102, HORSEHEADS, NY 14845-8302
(607) 795-1666
(607) 796-0839
Mailing address
571 SAINT JOSEPHS BLVD FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
(607) 873-1244
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101263850
VA
207X00000X
Orthopaedic Surgery Physician
Primary
297745
NY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
297745
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05595139
—
NY
05
—
103666997
—
PA
Enumeration date
06/17/2013
Last updated
12/01/2020
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