Smith, C Richard
Smith, C Richard is an individual health care provider with primary practice located at 2150 Gettler St Ste 400 , Dyer IN 46311-2385. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Cardiology, which is considered as his primary health care specialty. Smith, C Richard can be contacted via phone (219) 865-0893.Contact Information
Primary practice address
2150 Gettler St Ste 400
Dyer IN 46311-2385
Phone: (219) 865-0893
Fax: (219) 865-3599
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 036-055627 | Illinois |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 02000747A | Indiana |
Profile Details
| NPI number | 1083699193 |
|---|---|
| LBN Legal business name | Smith, C Richard |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 12th, 2005 |
| Last updated | Mar 17th, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083699193 | NPPES |
| Illinois | MEDICAID | 036055627 | |
| Illinois | MEDICAID | 100338620A |
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