Individual
JESS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110007462
VA
363A00000X
Physician Assistant
1098380
—
363A00000X
Physician Assistant
Primary
51720
CA
363A00000X
Physician Assistant
C0007584
MD
Other
Enumeration date
11/01/2011
Last updated
10/18/2023
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