MEDICARE: JEFFREY WINSTON SMITH DC

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	111N00000X	Chiropractor	DC24901	CA
2	111N00000X	Chiropractor	3647	OR

General Provider Information

NPI Number	:	1588788111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY WINSTON SMITH DC

Provider Business Mailing Address
First Line	:	PO BOX 1910
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-0109
Country	:	US
Telephone Number	:	541-810-2332
Fax Number	:	541-205-3822

Provider Business Practice Location Address
First Line	:	2041 RADCLIFFE AVE
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-3322
Country	:	US
Telephone Number	:	541-810-2332
Fax Number	:	541-205-3822

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

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	12/12/2023

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