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NPI Code Detail

MEDICARE: DR. RANDALL HOWARD SMITH M.D.

MEDICARE: DR. RANDALL HOWARD 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
1208600000XSurgery Physician045481OH

Other Identifiers

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

General Provider Information

NPI Number : 1699737114
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RANDALL HOWARD SMITH M.D.
Provider Business Mailing Address
First Line : 1930 STATE ROUTE 59
Second Line : SUITE D
City : KENT
State : OH
Zip : 44240-4112
Country : US
Telephone Number : 330-678-5447
Fax Number : 330-678-5638
Provider Business Practice Location Address
First Line : 1930 STATE ROUTE 59
Second Line : SUITE D
City : KENT
State : OH
Zip : 44240-4112
Country : US
Telephone Number : 330-678-5447
Fax Number : 330-678-5638
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2006
Last Update Date : 07/08/2007

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