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General NPI Number Information
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NPI Number | 1427021476
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Entity Type | Organization
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Legal Business Name | SOUTHPOINTE PEDIATRICS, PC
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Dates
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Enumeration Date | 02/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8851 SOUTHPOINTE DR C-2
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-0975
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Country | US
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Telephone | 317-887-3344
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Fax | 317-885-5018
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Provider Business Mailing Address
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Address Line | 8851 SOUTHPOINTE DR C-2
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-0975
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Country | US
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Telephone | 317-887-3344
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Fax | 317-885-5018
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREGORY L SMITH
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Credential | MD
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Telephone | 317-887-3344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 50003909
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License Number State | IN
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