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General NPI Number Information
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NPI Number | 1326147430
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Entity Type | Organization
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Legal Business Name | J. GERALD SMITH, MD
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 09/23/2010
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Provider Practice Location Address
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Address Line | 390 TOLL GATE RD SUITE 101
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City | WARWICK
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State | RI
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Zip | 02886-4326
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Country | US
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Telephone | 401-737-2280
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Fax |
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Provider Business Mailing Address
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Address Line | 390 TOLL GATE RD SUITE 101
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City | WARWICK
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State | RI
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Zip | 02886-4326
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Country | US
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Telephone | 401-737-2280
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Fax |
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | J. GERALD SMITH
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Credential | MD
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Telephone | 401-738-4074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | MD04196
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License Number State | RI
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