MEDICARE: DR. KRISTIN SMITH D.O.

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	207P00000X	Emergency Medicine Physician	2086	WV
2	207P00000X	Emergency Medicine Physician	OS014061	PA

General Provider Information

NPI Number	:	1912022153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTIN SMITH D.O.

Provider Business Mailing Address
First Line	:	343 ADAMIK RD
Second Line	:
City	:	CLARKSVILLE
State	:	PA
Zip	:	15322-7395
Country	:	US
Telephone Number	:	724-986-5858
Fax Number	:	724-883-3985

Provider Business Practice Location Address
First Line	:	343 ADAMIK RD
Second Line	:
City	:	CLARKSVILLE
State	:	PA
Zip	:	15322-7395
Country	:	US
Telephone Number	:	724-986-5858
Fax Number	:

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

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	11/21/2023

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