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NPI Code Detail

MEDICARE: JEREMY D SMITH MD

MEDICARE: JEREMY D SMITH MD
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
1207R00000XInternal Medicine Physician231633-1NY
22084P0800XPsychiatry Physician231633NY
32084P0800XPsychiatry Physician231633-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629011952
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEREMY D SMITH MD
Provider Business Mailing Address
First Line : 1111 ELMWOOD AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-3005
Country : US
Telephone Number : 585-241-1757
Fax Number :
Provider Business Practice Location Address
First Line : 1111 ELMWOOD AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-3005
Country : US
Telephone Number : 585-241-1757
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2006
Last Update Date : 07/05/2023

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