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Individual

GARY A SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ARNP

Contact information

Practice address
1710 HWY 121 N. BYPASS, SUITE I, MURRY, KY 42071
(270) 226-1118
(270) 226-1119
Mailing address
PO BOX 636961, CINCINNATI, OH 45263-6961
(513) 981-5130
(513) 981-5015

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3003886
KY
363LF0000X
Family Nurse Practitioner
3003886
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000732995
BCBS
KY
05
7100157310
KY
01
P00956479
RAILROAD MEDICARE
KY
Enumeration date
10/25/2005
Last updated
05/22/2015
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