Provider Demographics
NPI:1760526305
Name:JASON A SMITH, MD. INC
Entity Type:Organization
Organization Name:JASON A SMITH, MD. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:A
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-726-0147
Mailing Address - Street 1:425 GREGORY LN
Mailing Address - Street 2:STE. 201
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-2880
Mailing Address - Country:US
Mailing Address - Phone:925-726-0147
Mailing Address - Fax:
Practice Address - Street 1:425 GREGORY LN
Practice Address - Street 2:STE. 201
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-2880
Practice Address - Country:US
Practice Address - Phone:925-726-0147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG84596207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU5931ZMedicare UPIN
CAZZZ27597ZMedicare ID - Type Unspecified
CA5537320001Medicare NSC