Healthcare Provider Details

I. General information

NPI: 1679369771
Provider Name (Legal Business Name): JOSHUA RAY SMITH DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 5 MILE RD STE 100
CINCINNATI OH
45230-2187
US

IV. Provider business mailing address

701 RAHLING RD APT 4409
LITTLE ROCK AR
72223-3009
US

V. Phone/Fax

Practice location:
  • Phone: 513-233-6980
  • Fax:
Mailing address:
  • Phone: 681-302-9563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: