MEDICARE: KAREN SUE SMITH M.D.

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	208000000X	Pediatrics Physician	35075528	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	:	1578517314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN SUE SMITH M.D.

Provider Business Mailing Address
First Line	:	1431 N MAIN AVE
Second Line	:
City	:	SIDNEY
State	:	OH
Zip	:	45365-1735
Country	:	US
Telephone Number	:	937-419-8687
Fax Number	:	937-419-8688

Provider Business Practice Location Address
First Line	:	915 W MICHIGAN ST. STE. 200
Second Line	:
City	:	SIDNEY
State	:	OH
Zip	:	45365-2491
Country	:	US
Telephone Number	:	937-498-4880
Fax Number	:	937-494-5295

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	05/21/2025

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