Smith, Gregory Dale
Smith, Gregory Dale is an individual health care provider with primary practice located at 2412 Ring Rd Ste 200, Elizabethtown KY 42701-5913. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Smith, Gregory Dale can be contacted via phone (270) 765-5926.Contact Information
Primary practice address
2412 Ring Rd Ste 200
Elizabethtown KY 42701-5913
Phone: (270) 765-5926
Fax: (270) 763-0051
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 38746 | Kentucky |
Profile Details
| NPI number | 1659375269 |
|---|---|
| LBN Legal business name | Smith, Gregory Dale |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 10th, 2005 |
| Last updated | Oct 27th, 2020 - about 6 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 | 1659375269 | NPPES |
| Kentucky | Other | 2447320000 | PASSPORT ADVANTAGE |
| Kentucky | Other | P00169467 | PASSPORT ADVANTAGE |
| Kentucky | Other | 000000337254 | PASSPORT ADVANTAGE |
| Kentucky | Other | 50006034 | PASSPORT ADVANTAGE |
| Kentucky | MEDICAID | 64087711 | PASSPORT ADVANTAGE |
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