Smith, Dwayne V

Smith, Dwayne V is an individual health care provider with primary practice located at 4900 Houston Rd , Florence KY 41042-4824. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Smith, Dwayne V can be contacted via phone (859) 212-4625.

Contact Information

Primary practice address
4900 Houston Rd Florence KY 41042-4824
Phone: (859) 212-4625
Fax: (859) 212-4638
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 23626 Kentucky

Profile Details

NPI number 1619969904
LBN Legal business name Smith, Dwayne V
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 22nd, 2005
Last updated Sep 30th, 2015 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619969904 NPPES
Kentucky Other P01134522 RR MEDICARE
Kentucky MEDICAID 200347010A RR MEDICARE
Kentucky Other 020049483 RR MEDICARE
Kentucky MEDICAID 64236268 RR MEDICARE
Kentucky MEDICAID 2626582 RR MEDICARE

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