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Individual

DR. JOHN MICHAEL SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2123 AUBURN AVE STE 201, CINCINNATI, OH 45219-2906
(513) 206-1170
(513) 206-1172
Mailing address
10506 MONTGOMERY ROAD, SUITE 302, CINCINNATI, OH 45242
(513) 865-5120
(513) 865-5121

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
35067018S
OH
208600000X
Surgery Physician
35492
KY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
35067018S
OH
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
35492
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000064644
ANTHEM
05
0219454
OH
01
1800135
UNITEDHEALTHCARE
05
200328230B
IN
01
310804060029
CARESOURCE
05
64960842
KS
01
67018
CHOICE CARE/HUMANA
01
8330
KY BCBS
05
913231700
FL
Enumeration date
07/10/2006
Last updated
10/28/2020
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