MEDICARE: DR. JAYNELL SMITH-CAMERON DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	PO002487	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	40029653	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	65404	OTHER	FL	BCBSFL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235276189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAYNELL SMITH-CAMERON DPM

Provider Business Mailing Address
First Line	:	PO BOX 2588
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32203-2588
Country	:	US
Telephone Number	:	904-354-1192
Fax Number	:	904-354-1193

Provider Business Practice Location Address
First Line	:	2105 PARK ST
Second Line	:	STE B
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-3871
Country	:	US
Telephone Number	:	904-354-1192
Fax Number	:	904-354-1193

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	03/07/2023

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Directions to “ DR. JAYNELL SMITH-CAMERON DPM” Practice Location

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