Provider Demographics
NPI:1952324766
Name:SMITH, JEFFREY MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MARK
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3750 CONVOY ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-3738
Mailing Address - Country:US
Mailing Address - Phone:858-278-8031
Mailing Address - Fax:858-278-1708
Practice Address - Street 1:3750 CONVOY ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-3738
Practice Address - Country:US
Practice Address - Phone:858-278-8031
Practice Address - Fax:858-278-1708
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2014-02-04
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Provider Licenses
StateLicense IDTaxonomies
CAG83625207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery