Individual
JOHN M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
555 N DUKE ST, LANCASTER, PA 17602-2250
(717) 544-5941
(717) 544-5907
Mailing address
PO BOX 4216, LANCASTER, PA 17604-4216
(717) 394-6028
(717) 394-9223
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25656
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000388816
ANTHEM BLUE FACET
KY
05
—
104362717
—
PA
05
—
200814750
—
IN
05
—
50009541
—
KY
05
—
64256563
—
KY
Enumeration date
08/04/2006
Last updated
08/13/2024
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