Dr JACK MICHAEL SMITH is a male medical professional, specializing in Pain Management. He graduated in from Temple University School Of Medicine.
SUSQUEHANNA PHYSICIAN SERVICES
1100 GRAMPIAN BLVD
WILLIAMSPORT
PA
177011909
Tel: 5703268457
| Npi | 1346687720 |
| Pac Id | 7214177500 |
| Professional Enrollment Id | I20180731001239 |
| Last Name | SMITH |
| First Name | JACK |
| Middle Name | MICHAEL |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | TEMPLE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | |
| Primary Specialty | PAIN MANAGEMENT |
| Secondary Specialty 1 | PHYSICAL MEDICINE AND REHABILITATION |
| Secondary Specialty 2 | |
| Secondary Specialty 3 | |
| Secondary Specialty 4 | |
| All Secondary Specialties | PHYSICAL MEDICINE AND REHABILITATION |
| Organization Legal Name | SUSQUEHANNA PHYSICIAN SERVICES |
| Group Practice Pac Id | 2264336460 |
| Number Of Group Practice Members | 338 |
| Line 1 Street Address | 1100 GRAMPIAN BLVD |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | WILLIAMSPORT |
| State | PA |
| Zip Code | 177011909 |
| Phone Number | 5703268457 |
| Hospital Affiliation Ccn 1 | 390045 |
| Hospital Affiliation Lbn 1 | WILLIAMSPORT REGIONAL MEDICAL CENTER |
| Hospital Affiliation Ccn 2 | 391316 |
| Hospital Affiliation Lbn 2 | UPMC SUSQUEHANNA SOLDIERS & SAILORS |
| Hospital Affiliation Ccn 3 | |
| Hospital Affiliation Lbn 3 | |
| Hospital Affiliation Ccn 4 | |
| Hospital Affiliation Lbn 4 | |
| Hospital Affiliation Ccn 5 | |
| Hospital Affiliation Lbn 5 | |
| Professional Accepts Medicare Assignment | Y |
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