Smith, Mark A

Smith, Mark A is an individual health care provider with primary practice located at 474 N Yellow Springs St , Springfield OH 45504-2463. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Smith, Mark A can be contacted via phone (937) 399-9500.

Contact Information

Primary practice address
474 N Yellow Springs St Springfield OH 45504-2463
Phone: (937) 399-9500
Fax: (937) 342-4236
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 35-047333 Ohio

Profile Details

NPI number 1164413100
LBN Legal business name Smith, Mark A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2005
Last updated Jan 4th, 2017 - about 9 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 1164413100 NPPES
Ohio Other 000000004428 ANTHEM
Ohio Other 004013993 ANTHEM
Ohio MEDICAID 0597966 ANTHEM

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