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General NPI Number Information
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NPI Number | 1942490420
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Entity Type | Individual
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Provider Name | JILLIAN KENNEDY SMITH MD
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Gender | Female
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Dates
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Enumeration Date | 07/31/2007
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 11 ROCK ROW STE 320
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City | WESTBROOK
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State | ME
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Zip | 04092-4877
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Country | US
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Telephone | 207-303-3300
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Fax | 207-250-2139
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Provider Business Mailing Address
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Address Line | 100 CAMPUS DR UNIT 121
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City | SCARBOROUGH
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State | ME
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Zip | 04074-7172
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Country | US
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Telephone | 207-396-7788
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD452016
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | MD452016
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | MD24706
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License Number State | ME
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