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General NPI Number Information
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NPI Number | 1750812293
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Entity Type | Organization
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Legal Business Name | SMITH FAMILY HEALTHCARE, LLP
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Dates
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Enumeration Date | 03/27/2017
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Last Update Date | 12/15/2021
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Provider Practice Location Address
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Address Line | 254 PINECREST DR
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City | GALLIPOLIS
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State | OH
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Zip | 45631-1347
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Country | US
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Telephone | 740-578-4824
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Fax | 740-578-4821
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Provider Business Mailing Address
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Address Line | 254 PINECREST DR
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City | GALLIPOLIS
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State | OH
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Zip | 45631-1347
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Country | US
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Telephone | 740-578-4824
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Fax | 740-578-4821
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Authorized Official
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Title or Position | PARTNER/NURSE PRACTITIONER
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Name | DIANNA KAY SMITH
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Credential |
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Telephone | 740-578-4824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | RN251827/NP06403
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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