Healthcare Provider Details

I. General information

NPI: 1770873168
Provider Name (Legal Business Name): JOHN M SMILO DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2011
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 CHESTNUT ST
COSHOCTON OH
43812-1164
US

IV. Provider business mailing address

234 CHESTNUT ST
COSHOCTON OH
43812-1164
US

V. Phone/Fax

Practice location:
  • Phone: 740-295-3325
  • Fax: 740-295-3327
Mailing address:
  • Phone: 740-295-3325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number36002663
License Number StateOH

VIII. Authorized Official

Name: JOHN M SMILO
Title or Position: DPM
Credential:
Phone: 740-295-3325