Individual provider · Type 1 NPI

Jacob Smith

Surgical Physician Assistant · Albuquerque, NM

NPI number 1457181968 Active

Practice location

2100 Louisiana Blvd NE Ste 410
Albuquerque, NM 87110-5412

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XNone listed
Medical Physician Assistant 363AM0700XNone listed

Surgical Physician Assistant: Definition to come...

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About NPI 1457181968

Jacob Smith's National Provider Identifier is 1457181968, issued on Aug 7, 2024. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Albuquerque, NM. The record was last updated on Aug 21, 2026.