MEDICARE: DR. JOHN E SMITH JR. M.D.

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	207RH0003X	Hematology & Oncology Physician	MA073316	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	1406833	OTHER	AMERIHEALTH
2	222144152	OTHER	INTERGROUP
3	1406833	OTHER	INDEPENCENCE BLUE CROSS
4	7100340	OTHER	AETNA PPO
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	222144152	OTHER	DEVON
7	1167146	OTHER	HORIZON NJ HEALTH
8	2807974	OTHER	AETNA PROVIDER NUMBER
9	1406833	OTHER	HIGHMARK BLUE CROSS
10	2094464000	OTHER	KEYSTONE HEALTHPLAN EAST
11	222144152	OTHER	MAGNACARE
12	222144152	OTHER	HEALTHCRE PAYOR COALITION
13	9922910-003	OTHER	CIGNA HEALTHCARE
14	222144152	OTHER	HORIZON BLUE CROSS
15	1406833	OTHER	PREMIERE BLUE
16	50001283	OTHER	CAPITAL BLUE CROSS

General Provider Information

NPI Number	:	1275521361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN E SMITH JR. M.D.

Provider Business Mailing Address
First Line	:	10 BRASS CASTLE RD
Second Line	:
City	:	WASHINGTON
State	:	NJ
Zip	:	08865-4327
Country	:	US
Telephone Number	:	908-454-0370
Fax Number	:	908-454-9858

Provider Business Practice Location Address
First Line	:	755 MEMORIAL PARKWAY SUITE 102
Second Line	:	HILLCREST PROFESSIONAL PLAZA
City	:	PHILLIPSBURG
State	:	NJ
Zip	:	08865-2774
Country	:	US
Telephone Number	:	908-454-0370
Fax Number	:	908-454-9858

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	02/20/2015

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