Individual
CHRISTOPHER M SMALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7440 JEFFERSON BLVD, LOUISVILLE, KY 40219
(502) 969-0975
(502) 969-0081
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36602
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000765744
ANTHEM - NCMA
KY
01
—
090778
SIHO - NCMA
KY
01
—
50037757
PASSPORT - NCMA - BULLITT
KY
01
—
50037759
PASSPORT - NCMA - LOUISVILLE
KY
05
—
64059066
—
KY
01
—
P01050143
RAILROAD MEDICARE
KY
Enumeration date
11/16/2005
Last updated
01/22/2021
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