Healthcare Provider Details

I. General information

NPI: 1922504034
Provider Name (Legal Business Name): OLIVIA FAYE SMITH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2018
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17840 CUMBERLAND RD
NOBLESVILLE IN
46060-5409
US

IV. Provider business mailing address

9615 E 148TH ST STE 1
NOBLESVILLE IN
46060-4371
US

V. Phone/Fax

Practice location:
  • Phone: 317-574-1254
  • Fax: 317-674-0060
Mailing address:
  • Phone: 317-574-1254
  • Fax: 317-674-0060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02006471A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number02006471A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: