Provider Demographics
NPI:1669457388
Name:SMITH, JOHN CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHRISTOPHER
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 938
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76540-0938
Mailing Address - Country:US
Mailing Address - Phone:254-634-6999
Mailing Address - Fax:254-200-4090
Practice Address - Street 1:1301 WONDER WORLD DR
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7533
Practice Address - Country:US
Practice Address - Phone:512-753-3627
Practice Address - Fax:254-200-4090
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-15
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH4708207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH4708OtherTWCC
TX123376905Medicaid
TX8A4081OtherBLUE CROSS BLUE SHIELD
TX123376905OtherSUPERIOR HEALTH CHIP
TXP00033862OtherRAILROAD MEDICARE