Provider Demographics
NPI:1831780329
Name:SMITH, DONALD S JR (AM)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:S
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:AM
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Mailing Address - Street 1:16 PEBBLE LN
Mailing Address - Street 2:
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046-2728
Mailing Address - Country:US
Mailing Address - Phone:610-931-1583
Mailing Address - Fax:
Practice Address - Street 1:16 PEBBLE LN
Practice Address - Street 2:
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-2728
Practice Address - Country:US
Practice Address - Phone:610-931-1583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy