Individual ProviderJohn Dewey SmithPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1 Medical Plaza Dr, Roseville, CA 95661-3037(916) 781-1000(510) 350-2600PECOS EnrollmentBased on the most recent information from CMS, provider John Dewey Smith does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1821010398Provider TypeIndividualFull NameSmith, John DeweyCredentialP.A-CGenderMaleSole ProprietorNoEnumeration Date7/24/2006Last Updated11/13/2007Contact InformationPractice LocationPractice Address1 Medical Plaza Dr, Roseville, CA 95661-3037Phone(916) 781-1000FaxUnlisted FaxMailing LocationMailing Address2100 Powell St, Ste 900, Emeryville, CA 94608-1826Phone(510) 350-2600Fax(510) 879-9100Provider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicensePA14503California