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NPI Code Detail

MEDICARE: J.W. SMITH, D.C., LLC

MEDICARE: J.W. SMITH, D.C., LLC
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
1261Q00000XClinic/Center
2261QM2500XMedical Specialty Clinic/Center
3261QH0100XHealth Service Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11588788111OTHERNPI

General Provider Information

NPI Number : 1932715935
Entity Type Code : Organization
Provider Name (Legal Business Name) : J.W. SMITH, D.C., LLC
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 : OWNER
Name : DR. JEFFREY WINSTON SMITH
Credential : DC
Telephone Number : 541-810-2332
Provider Enumeration Date : 09/16/2020
Last Update Date : 12/12/2023

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