MEDICARE: MS. TEQUILA 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
1	171M00000X	Case Manager/Care Coordinator		OH

General Provider Information

NPI Number	:	1619848116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TEQUILA SMITH

Provider Business Mailing Address
First Line	:	500 MADISON AVE STE 200
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43604-1230
Country	:	US
Telephone Number	:	513-440-3940
Fax Number	:

Provider Business Practice Location Address
First Line	:	1705 SECTION RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-3313
Country	:	US
Telephone Number	:	513-407-8984
Fax Number	:

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

Provider Enumeration Date	:	09/16/2025
Last Update Date	:	09/16/2025

Similar Medicare Providers

1114086444 — DR. BRENT A WILLIAMS DDS
Practice Location Address:

1719 SECTION RD
CINCINNATI, OH
45237-3313

Practice Phone: 513-531-4069
Practice Fax: 513-531-4419

1598128423 — INSPIRATIONAL SPEAKING,LLC/I DREAM ACADEMY
Practice Location Address:

1705 SECTION RD
CINCINNATI, OH
45237-3313

Practice Phone: 513-407-8984
Practice Fax: 513-407-8959

1790287480 — MR. DE'RON SMITH OWDS, CCME, CDCA,
Practice Location Address:

1705 SECTION RD
CINCINNATI, OH
45237-3313

Practice Phone: 513-512-2169
Practice Fax: 513-407-8959

1174329205 — MARC CHRISTOPHER FRISON
Practice Location Address:

1705 SECTION RD
CINCINNATI, OH
45237-3313

Practice Phone: 513-407-8984
Practice Fax: 513-407-8959

1811868318 — MR. DARRELL LEE SLATER JR.
Practice Location Address:

1705 SECTION RD
CINCINNATI, OH
45237-3313

Practice Phone: 513-407-8984
Practice Fax:

1902751464 — PATRICIA MARIE FULTON
Practice Location Address:

1999 FAYWOOD DR
CINCINNATI, OH
45238-3313

Practice Phone: 513-368-9610
Practice Fax:

Directions to “ MS. TEQUILA SMITH ” 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.