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General NPI Number Information
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NPI Number | 1558686360
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Entity Type | Individual
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Provider Name | JACOB BRIGHAM SMITH MD
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Gender | Male
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Dates
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Enumeration Date | 04/05/2010
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 2250 S ANKENY BLVD
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City | ANKENY
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State | IA
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Zip | 50023-9093
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Country | US
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Telephone | 515-725-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 2250 S ANKENY BLVD
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City | ANKENY
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State | IA
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Zip | 50023-9093
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Country | US
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Telephone | 515-725-1400
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZF0201X
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Taxonomy Name | Forensic Pathology Physician
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License Number | 56759-20
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207ZF0201X
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Taxonomy Name | Forensic Pathology Physician
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License Number | MD-48443
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License Number State | IA
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