MEDICARE: FOOT SERVICES BY JAYNELL M SMITH-CAMERON

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

General Provider Information

NPI Number	:	1285336040
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOOT SERVICES BY JAYNELL M SMITH-CAMERON

Provider Business Mailing Address
First Line	:	PO BOX 2588
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32203-2588
Country	:	US
Telephone Number	:	904-294-1192
Fax Number	:

Provider Business Practice Location Address
First Line	:	3115 SPRING GLEN RD STE 507
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-5907
Country	:	US
Telephone Number	:	904-294-1192
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. JAYNELL SMITH-CAMERON
Credential	:	DPM
Telephone Number	:	904-294-1192

Provider Enumeration Date	:	03/17/2023
Last Update Date	:	04/10/2023

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