Individual
DR. STEPHEN Z. SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3950 KRESGE WAY, SUITE 305, LOUISVILLE, KY 40207-4637
(502) 896-8803
Mailing address
3950 KRESGE WAY STE 404, LOUISVILLE, KY 40207-4637
(502) 896-8803
(502) 896-8863
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
17338
KY
207ND0900X
Dermatopathology Physician
17338
KY
207NS0135X
Procedural Dermatology Physician
17338
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000046994
ANTHEM BCBS
KY
01
—
070003785
RAILROAD MEDICARE
KY
01
—
1066659
PASSPORT
KY
01
—
2434641000
PASSPORT ADVANTAGE
KY
05
—
64173388
—
KY
Enumeration date
07/14/2005
Last updated
10/02/2018
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