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NPI 1235363839

NPI 1235363839 : BENJAMIN EDWARD SMITH DO : HENDERSON, KY

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General NPI Number Information
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    NPI Number           |    1235363839
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    Entity Type          |    Individual 
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    Provider Name        |    BENJAMIN EDWARD SMITH DO
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/11/2009
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    Last Update Date     |    05/28/2024
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Provider Practice Location Address
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    Address Line         |    3135 ZION RD SUITE B
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    City                 |    HENDERSON
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    State                |    KY
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    Zip                  |    42420-9204
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    Country              |    US
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    Telephone            |    270-826-9444
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    Fax                  |    270-826-9002
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Provider Business Mailing Address
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    Address Line         |    PO BOX 23229 
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    City                 |    OWENSBORO
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    State                |    KY
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    Zip                  |    42304-3229
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    Country              |    US
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    Telephone            |    270-688-1330
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    Fax                  |    270-688-1338
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207L00000X
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    Taxonomy Name        |    Anesthesiology Physician
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    License Number       |    03631
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    License Number State |    KY
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Taxonomy #2
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    Taxonomy Code        |    208VP0000X
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    Taxonomy Name        |    Pain Medicine Physician
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    License Number       |    03631
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    License Number State |    KY
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