Healthcare Provider Details

I. General information

NPI: 1871502773
Provider Name (Legal Business Name): RONALD ENGLISH SMITH JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 GIBNER RD STE 1 CARLISLE BARRACKS
CARLISLE PA
17013-5086
US

IV. Provider business mailing address

813 GOBIN DR
CARLISLE PA
17013-1514
US

V. Phone/Fax

Practice location:
  • Phone: 717-245-3041
  • Fax: 717-245-3815
Mailing address:
  • Phone: 717-249-8951
  • Fax: 717-245-3815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number6819
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: