Bert Jackson Smith is a Internal Medicine Physician in the JOHNSON CITY area. Bert Jackson Smith primary office location is at 2717 E. OAKLAND AVENUE and new patients are welcome to contact this healthcare provider for an appointment. The NPI number is 1497839070 and the information was updated less than a year ago.
We have not detected any Exclusions tied directly to this NPI.
Accepts Medicare Assignment: Unknown
Is sole proprietor: YES
Participates in PECOS: YES (See any PECOS details below)
License Number | State |
---|---|
0101256885 | VA |
43425 | TN |
Board Certifications |
---|
Internal Medicine |
Type/Issuer | Identifier | State |
---|---|---|
MEDICAID | 1506626 | TN |
MEDICAID | 7100075230 | KY |
MEDICAID | 1506627 | TN |
MEDICAID | 1497839070 | VA |
MEDICAID | Q002701 | TN |
MEDICAID | 1497839070 | NC |
RR MEDICARE | P00844330 | TN |
MEDICAID | 5913158 | NC |
Taxonomy | State | Primary? |
---|---|---|
Internal Medicine Physician - Taxonomy Code 207R00000X | VA | Y |
Internal Medicine Physician - Taxonomy Code 207R00000X | TN | N |
Participates in PECOS: | YES |
PECOS Individual Enrollment ID: | |
PECOS Individual PAC ID: | |
Eligible to order/refer Part B Clinical Laboratory and Imaging | Yes |
Eligible to order/refer Durable Medical Equipment (DME) | Yes |
Eligible to order/refer Home Health Agency (HHA) | Yes |
Eligible to order/refer Power Mobility Devices (PMD) | Yes |