Individual
THOMAS ROBERT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1720 BEACON ST, FORT WAYNE, IN 46805-4749
(856) 693-2024
Mailing address
11710 HEMINGWAY BAY, FORT WAYNE, IN 46814-8233
(856) 693-2024
Taxonomy
Speciality
Code
Description
License number
State
1835P1300X
Psychiatric Pharmacist
Primary
26024785A
IN
Other
Enumeration date
07/10/2018
Last updated
07/10/2018
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