Individual
DR. DEANE L SMITH II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4055 GATEWAY BLVD, NEWBURGH, IN 47630-7451
(812) 858-3051
(812) 858-3060
Mailing address
PO BOX 632111, CINCINNATI, OH 45263-2111
(812) 450-6815
(812) 450-6822
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01054184A
IN
208C00000X
Colon & Rectal Surgery Physician
Primary
01054184A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000192623
ANTHEM BC/BS
IN
01
—
01054184A
STATE LICENSE
IN
05
—
200248150
—
IN
05
—
64041460
—
KY
Enumeration date
07/13/2005
Last updated
04/09/2026
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