Provider Demographics
NPI:1144245242
Name:SMITH, JOHN RUTHERFOORD JR (AUD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:RUTHERFOORD
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 THE VILLAGE OVERLOOK
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-2616
Mailing Address - Country:US
Mailing Address - Phone:828-586-7474
Mailing Address - Fax:828-586-7473
Practice Address - Street 1:38 THE VILLAGE OVERLOOK
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-2616
Practice Address - Country:US
Practice Address - Phone:828-586-7474
Practice Address - Fax:828-586-7473
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3043231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist