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Contact Information

JERRY D SMITH JR, PSY.D.
18TH MEDICAL GROUP
UNIT 5142
APO, AP96368-5142
 Phone: 315-630-4780
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for JERRY D SMITH JR · (Male)

NPI Number 1265781645
Status Active
Credentials PSY.D. (Doctor of Psychology)
Entity Individual
Enumeration date 08/31/2012
Last updated 04/13/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • TX License # 36009
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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