Healthcare Provider Details

I. General information

NPI: 1477410009
Provider Name (Legal Business Name): ADAM GEORGE SMITH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 W MARKET ST
AKRON OH
44313-7000
US

IV. Provider business mailing address

644 MUSKINGUM AVE NW
BREWSTER OH
44613-1028
US

V. Phone/Fax

Practice location:
  • Phone: 234-200-1219
  • Fax:
Mailing address:
  • Phone: 330-327-9576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberAPS.007120
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: