Theodore Roosevelt Smith JR. PSY.D.

NPI 1013928050 - Psychologist - 103T00000X

NPI Details
NPI 1013928050
Gender Male
Enumeration Date 08/11/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
6817 SOUTHPOINT PKWY
SUITE 2303
JACKSONVILLE FL, 32216-6282, US
Phone (904) 332-7431
Fax (904) 332-7408
Business Location
1063 FOXMEADOW TRL
MIDDLEBURG FL, 32068-3215, US
Phone (904) 282-3522
Fax (904) 282-8482
Toxanomy
Taxonomy Code 103T00000X
License State Florida
License Number PY3851
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According to our database, Dr. Theodore Roosevelt Smith JR. PSY.D. NPI is 1013928050, taxonomy code is 103T00000X and license number is PY3851, license state is located at Florida. Theodore Roosevelt Smith JR. PSY.D. physically located at 6817 Southpoint Pkwy, Jacksonville FL, 32216-6282. NPI Number Theodore Roosevelt Smith JR. PSY.D. has the Individual type.

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1013928050 NPI number is provided on an as is basis without warranty of any kind. 1013928050 is maintained by the National Plan & Provider Enumeration System. The contents of Theodore Roosevelt Smith JR. PSY.D. are for informational purposes only.