# VERSAILLES FAMILY MEDICINE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548316763
- **Authorized official:** BRIAN A SMITH MD (OWNER)
- **Authorized official phone:** (859) 879-0111

## Contact information

- **Practice address:** 460 WILSON AVE, FIRST FLOOR, VERSAILLES, KY 40383-1947
- **Practice address phone:** (859) 879-0111
- **Practice address fax:** (859) 879-0363
- **Mailing address:** 460 WILSON AVE, FIRST FLOOR, VERSAILLES, KY 40383-1947
- **Mailing address phone:** (859) 879-0111
- **Mailing address fax:** (859) 879-0363

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 40454 | KY | Yes |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/28/2007
- **Last updated:** 05/19/2022