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General NPI Number Information
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NPI Number | 1295123875
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Entity Type | Organization
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Legal Business Name | J E SMITH MD LLC
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Dates
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Enumeration Date | 01/05/2015
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Last Update Date | 01/05/2015
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Provider Practice Location Address
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Address Line | 926 INCLINE WAY UNIT 150
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City | INCLINE VILLAGE
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State | NV
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Zip | 89451-7933
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Country | US
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Telephone | 605-376-2754
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Fax | 775-831-4814
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Provider Business Mailing Address
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Address Line | 5245 CEDARWOOD DR
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City | RENO
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State | NV
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Zip | 89511-8010
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Country | US
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Telephone | 605-376-2754
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Fax | 775-831-4814
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JANET E SMITH
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Credential | MD
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Telephone | 605-376-2754
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 13528
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License Number State | NV
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