Doctor Name: | MR. JEREMY TODD SMITH |
NPI Number: | 1144416439 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | OTR/L |
License Number: | 5348 |
Business Practice Address: | Reilly Road Fort Bragg, NC - 283100001 |
Business Phone Number: | 9109076000 |
Business Fax Number: | |
Mailing Address: | Reilly Road, FORT BRAGG |
State: | NC |
Postal Code: | 283100001 |
Phone Number: | 9109076000 |
Fax Number: | |
NPI Enumeration Date: | 09/20/2007 |
NPI Last Update Date: | 09/20/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 286500000X |
License Number: | 5348 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Hospitals |
Taxonomy Classification: | Military Hospital |
Taxonomy Specialization: | |
Taxonomy Definition: | A health care facility operated by the Department of Defense. |