Physician Compare National (NPI:1316029077)

HEALTHCARE PROVIDER: KENNETH RONALD SMITH MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1316029077
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7618984691
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20081205000061
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SMITH
	Individual professional last name
Provider First Name	KENNETH
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1992
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	8991 REDDEN RD
	Group Practice or individual's line 1 address
City	BRIDGEVILLE
	Group Practice or individual's city
State	DE
	Group Practice or individual's state
Zip Code	199334746
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3023373300
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	080006
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NANTICOKE MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	080009
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BAYHEALTH - MILFORD MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	080007
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	BEEBE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y