=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477410009
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ADAM GEORGE SMITH
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/06/2026
-----------------------------------------------------
Last Update Date | 01/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1815 W MARKET ST
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44313-7000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 234-200-1219
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 644 MUSKINGUM AVE NW
-----------------------------------------------------
City | BREWSTER
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44613-1028
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-327-9576
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 175T00000X
-----------------------------------------------------
Taxonomy Name | Peer Specialist
-----------------------------------------------------
License Number | APS.007120
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------