Smith, David Allen
Smith, David Allen is an sole proprietor health care provider with primary practice located at 7613 W Jefferson Blvd Ste 200 , Fort Wayne IN 46804-4182. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Pediatric Surgery. Allopathic & Osteopathic Physicians / Pediatric Surgery is his primary health care specialty. Smith, David Allen can be contacted via phone (260) 469-7337.Contact Information
Primary practice address
7613 W Jefferson Blvd Ste 200
Fort Wayne IN 46804-4182
Phone: (260) 469-7337
Fax: (260) 469-7340
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 01040403A | Indiana |
| Allopathic & Osteopathic Physicians / Pediatric Surgery | 2086S0120X | 01040403A | Indiana |
Profile Details
| NPI number | 1962405993 |
|---|---|
| LBN Legal business name | Smith, David Allen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 23rd, 2005 |
| Last updated | Mar 31st, 2014 - about 12 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 | 1962405993 | NPPES |
| Ohio | MEDICAID | 2080877 | |
| Ohio | MEDICAID | 104683309 | |
| Ohio | MEDICAID | 200049180 |
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