Provider Demographics
NPI:1477592541
Name:SMART, JAMES BENNY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BENNY
Last Name:SMART
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:2 SHIRCLIFF WAY
Mailing Address - Street 2:STE 700 DEPAUL BLDG.
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-4763
Mailing Address - Country:US
Mailing Address - Phone:904-389-5333
Mailing Address - Fax:904-389-5332
Practice Address - Street 1:2 SHIRCLIFF WAY
Practice Address - Street 2:STE 700 DEPAUL BLDG.
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4763
Practice Address - Country:US
Practice Address - Phone:904-389-5333
Practice Address - Fax:904-389-5332
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2016-12-30
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Provider Licenses
StateLicense IDTaxonomies
FLME76344207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269051900Medicaid
FL43894ZMedicare PIN
FLG17344Medicare UPIN