Provider Demographics
NPI:1245991207
Name:SMITH, JERI CATON (PA-C)
Entity type:Individual
Prefix:
First Name:JERI
Middle Name:CATON
Last Name:SMITH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JERI
Other - Middle Name:CATON
Other - Last Name:SMOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1164 BUFFALO RUN
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GAP
Mailing Address - State:TX
Mailing Address - Zip Code:79508-2040
Mailing Address - Country:US
Mailing Address - Phone:325-665-5347
Mailing Address - Fax:
Practice Address - Street 1:1164 BUFFALO RUN
Practice Address - Street 2:
Practice Address - City:BUFFALO GAP
Practice Address - State:TX
Practice Address - Zip Code:79508-2040
Practice Address - Country:US
Practice Address - Phone:325-665-5347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant