Smith, Kevin
Smith, Kevin is an individual health care provider with primary practice located at 1225 E Coolspring Ave , Michigan City IN 46360-6312. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Smith, Kevin can be contacted via phone (219) 861-8161.Contact Information
Primary practice address
1225 E Coolspring Ave
Michigan City IN 46360-6312
Phone: (219) 861-8161
Fax: (219) 873-9504
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 10000208A | Indiana |
Profile Details
| NPI number | 1396716460 |
|---|---|
| LBN Legal business name | Smith, Kevin |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 27th, 2006 |
| Last updated | Mar 22nd, 2021 - about 5 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 | 1396716460 | NPPES |
| Indiana | Other | 000000369959 | ANTHEM |
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