MEDICARE: DR. CHRISTOPHER J SMITH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	41585	KY
2	207R00000X	Internal Medicine Physician	41585	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	P00922874	OTHER	KY	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000000008876	OTHER	OH	ANTHEM
4	000000560926	OTHER		ANTHEM
5	0420604	OTHER	OH	UNITED HEALTH CARE
6	634925	OTHER	OH	AETNA

General Provider Information

NPI Number	:	1205837069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER J SMITH M.D.

Provider Business Mailing Address
First Line	:	PO BOX 635283
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-5283
Country	:	US
Telephone Number	:	859-341-0288
Fax Number	:	859-341-7482

Provider Business Practice Location Address
First Line	:	85 NORTH GRAND AVENUE
Second Line	:
City	:	FT. THOMAS
State	:	KY
Zip	:	41075-1793
Country	:	US
Telephone Number	:	859-912-7211
Fax Number	:	859-655-6674

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	06/18/2024

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