Healthcare Provider Details

I. General information

NPI: 1184722589
Provider Name (Legal Business Name): ROBERT J SMYTH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 05/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2859 BOUDINOT AVENUE SUITE 302
CINCINNATI OH
45238
US

IV. Provider business mailing address

2730 OBSERVATORY AVENUE
CINCINNATI OH
45208-2108
US

V. Phone/Fax

Practice location:
  • Phone: 513-244-2900
  • Fax: 513-321-0700
Mailing address:
  • Phone: 513-321-2211
  • Fax: 513-321-0700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number37770
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: