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General NPI Number Information
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NPI Number | 1952388035
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Entity Type | Individual
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Provider Name | DONALD G. SMITH JR. MD
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Gender | Male
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 05/19/2021
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Provider Practice Location Address
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Address Line | 795 SIM HODGIN PKWY
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City | RICHMOND
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State | IN
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Zip | 47374
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Country | US
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Telephone | 765-966-5949
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Fax | 765-962-6268
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Provider Business Mailing Address
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Address Line | 1100 REID PARKWAY MEDICAL STAFF SERVICES
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City | RICHMOND
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State | IN
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Zip | 47374-1157
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Country | US
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Telephone | 765-935-8802
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Fax | 765-983-3219
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01039281A
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License Number State | IN
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