Individual
TIMOTHY JAMES SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1911 HAZEL AVE, MEDFORD, OR 97501-1630
(541) 774-3950
Mailing address
1911 HAZEL AVE, MEDFORD, OR 97501-1630
(541) 774-3950
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/06/2011
Last updated
01/06/2011
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