James Bernard Smith Jr., M.D., PH.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

4301041027 Issued in MI

Practice address

22250 Providence Dr
Suite 203
Southfield, MI 48075-4825

Phone

(248) 569-4897

Fax

(248) 569-5226

NPI assigned

May 18, 2006

Last updated

Jan 15, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263513600000",
    "number": "1336192400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6685 FRANKLIN RD",
            "city": "BLOOMFIELD",
            "state": "MI",
            "postal_code": "483012924",
            "telephone_number": "248-932-2813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR",
            "address_2": "SUITE 203",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754825",
            "telephone_number": "248-569-4897",
            "fax_number": "248-569-5226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JAMES",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2010-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301041027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3017905",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Isabella Smith
• Isaiah R Smith
• Jackson Smith, DPT
• Jacqueline Elizabeth Smith, AGPCNP-BC
• Jalisa Smith
• Jasma Smith
• Johnny L Smith, M.S.
• Juan Smith
• Katherine Lawson Smith, LMSW
• Kavena Smith, RN

• Urology Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Urology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.