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NPI Code Detail

MEDICARE: ERNEST E. SMITH MD

MEDICARE: ERNEST E. SMITH MD
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
12080P0006XDevelopmental - Behavioral Pediatrics Physician01024824IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376615856
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERNEST E. SMITH MD
Provider Business Mailing Address
First Line : 8840 COMMERCE PARK PL STE E
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-3129
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4740 KINGSWAY DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-1521
Country : US
Telephone Number : 317-582-8290
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 04/27/2016

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Directions to “ ERNEST E. SMITH MD” Practice Location

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