| John Stewart Michael Smith Md | |
|
14088 Alabama St Jay FL 32565-1036 | |
| (850) 675-4546 | |
| (850) 675-4548 |
| Full Name | John Stewart Michael Smith Md |
|---|---|
| Speciality | Family Medicine |
| Location | 14088 Alabama St, Jay, Florida |
| Authorized Official Name and Position | John Stewart Michael Smith (OWNER/PRESIDENT) |
| Authorized Official Contact | 8506754546 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John Stewart Michael Smith Md Po Box 10 Jay FL 32565-0010 Ph: (850) 675-4546 | John Stewart Michael Smith Md 14088 Alabama St Jay FL 32565-1036 Ph: (850) 675-4546 |
| NPI Number | 1497014161 |
|---|---|
| Provider Enumeration Date | 05/15/2012 |
| Last Update Date | 10/26/2012 |
| Medicare PECOS PAC ID | 2567612666 |
|---|---|
| Medicare Enrollment ID | O20121026000158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497014161 | NPI | - | NPPES |
| 751241 | Other | COVENTRY | |
| 2553182 | Other | UNITED HEALTHCARE | |
| 592200521 | Other | CHAMPVA | |
| W560 | Other | WELLCARE | |
| 59180291 | Other | BLUE CROSS AND BLUE SHIELD OF ALABAMA | |
| 7839652 | Other | AETNA | |
| P00368813 | Other | RAILROAD MEDICARE | |
| 272533900 | Medicaid | FL | |
| 592200521 | Other | TRICARE | |
| 592200521 | Other | HUMANA | |
| 009996365 | Other | AL | ALACAID |
| 01512 | Other | BLUE CROSS AND BLUE SHIELD OF FLORIDA | |
| 2357174 | Other | CIGNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME89102 (Florida) | Primary |
| Provider Name | John-stewart Michael Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497710313 PECOS PAC ID: 7517999758 Enrollment ID: I20050908000388 |
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