Individual
MR. JEFFREY D SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
375 DIXMYTH AVE, CINCINNATI, OH 45220-2475
(513) 872-2432
(513) 872-8857
Mailing address
PO BOX 632572, CINCINNATI, OH 45263-2572
(800) 341-2666
(859) 341-7867
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN178560
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000003794
ANTHEM
OH
05
—
0237470
—
OH
05
—
200129720
—
IN
01
—
430030502
RR MEDICARE PALMETTO GBA
OH
05
—
74455320
—
KY
Enumeration date
05/03/2006
Last updated
07/19/2021
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