MEDICARE: DR. COLLEEN SMITH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	35079346	OH
2	207Q00000X	Family Medicine Physician	35-079346	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255330965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COLLEEN SMITH MD

Provider Business Mailing Address
First Line	:	1 HEALTHY PL
Second Line	:	SUITE 101
City	:	PATASKALA
State	:	OH
Zip	:	43062-7067
Country	:	US
Telephone Number	:	220-564-1900
Fax Number	:	220-564-1901

Provider Business Practice Location Address
First Line	:	1 HEALTHY PL
Second Line	:	SUITE 101
City	:	PATASKALA
State	:	OH
Zip	:	43062-7067
Country	:	US
Telephone Number	:	220-564-1900
Fax Number	:	220-564-1901

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	03/24/2023

Similar Medicare Providers

1942249735 — DALIA S ELKHAIRI MD
Practice Location Address:

1 HEALTHY PL , SUITE 201
PATASKALA, OH
43062-7067

Practice Phone: 740-348-1920
Practice Fax: 740-348-1921

1104869700 — TIFFANY E.D. INGLIS M.D.
Practice Location Address:

1 HEALTHY PL , SUITE 201
PATASKALA, OH
43062-7067

Practice Phone: 220-564-1920
Practice Fax: 220-564-1921

1851325526 — LICKING MEMORIAL PROFESSIONAL CORP
Practice Location Address:

1 HEALTHY PL , SUITE 101
PATASKALA, OH
43062-7067

Practice Phone: 740-348-1900
Practice Fax: 740-348-1901

1235159674 — LICKING MEMORIAL PROFESSIONAL CORP.
Practice Location Address:

1 HEALTHY PL , SUITE 103
PATASKALA, OH
43062-7067

Practice Phone: 740-348-1920
Practice Fax: 740-348-1921

1295809614 — LICKING MEMORIAL PROFESSIONAL CORP.
Practice Location Address:

1 HEALTHY PL , SUITE 105
PATASKALA, OH
43062-7067

Practice Phone: 740-348-1930
Practice Fax: 740-348-1931

1952479115 — CONNIE S JENKINS MD
Practice Location Address:

1 HEALTHY PL , SUITE 105
PATASKALA, OH
43062-7067

Practice Phone: 740-348-1930
Practice Fax: 740-348-1931

Directions to “ DR. COLLEEN SMITH MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.