Provider Demographics
NPI:1972723682
Name:SMAY, JEWEL D MONTGOMERY (MD)
Entity Type:Individual
Prefix:DR
First Name:JEWEL
Middle Name:D MONTGOMERY
Last Name:SMAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JEWEL
Other - Middle Name:DANIELLE
Other - Last Name:MONTGOMERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8007 S GALVESTON CT
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74132-2859
Mailing Address - Country:US
Mailing Address - Phone:312-480-1424
Mailing Address - Fax:
Practice Address - Street 1:20 YORK ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-688-2294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036126055207LP3000X
ARE-17436207L00000X, 207LP3000X
OK29202207LP3000X
CT76483207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology