Provider Demographics
NPI:1275521361
Name:SMITH, JOHN E JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10 BRASS CASTLE RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-4327
Mailing Address - Country:US
Mailing Address - Phone:908-454-0370
Mailing Address - Fax:908-454-9858
Practice Address - Street 1:755 MEMORIAL PARKWAY SUITE 102
Practice Address - Street 2:HILLCREST PROFESSIONAL PLAZA
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-2774
Practice Address - Country:US
Practice Address - Phone:908-454-0370
Practice Address - Fax:908-454-9858
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2015-02-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA073316207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1406833OtherAMERIHEALTH
222144152OtherINTERGROUP
1406833OtherINDEPENCENCE BLUE CROSS
7100340OtherAETNA PPO
NJ8828105Medicaid
222144152OtherDEVON
1167146OtherHORIZON NJ HEALTH
2807974OtherAETNA PROVIDER NUMBER
1406833OtherHIGHMARK BLUE CROSS
2094464000OtherKEYSTONE HEALTHPLAN EAST
222144152OtherMAGNACARE
222144152OtherHEALTHCRE PAYOR COALITION
9922910-003OtherCIGNA HEALTHCARE
222144152OtherHORIZON BLUE CROSS
1406833OtherPREMIERE BLUE
50001283OtherCAPITAL BLUE CROSS
222144152OtherDEVON
NJ326707Medicare PIN
222144152OtherHORIZON BLUE CROSS
7100340OtherAETNA PPO