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NPI Code Detail

MEDICARE: CARL SMITH

MEDICARE: CARL SMITH
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1598473324
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARL SMITH
Provider Business Mailing Address
First Line : 520 SOLIDA RD
Second Line :
City : SOUTH POINT
State : OH
Zip : 45680-9347
Country : US
Telephone Number : 740-523-0097
Fax Number :
Provider Business Practice Location Address
First Line : 520 SOLIDA RD
Second Line :
City : SOUTH POINT
State : OH
Zip : 45680-9347
Country : US
Telephone Number : 740-523-0097
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2022
Last Update Date : 11/10/2022

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Directions to “ CARL SMITH ” Practice Location

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