Organization
TIMOTHY W SMITH DO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY WILLIAM SMITH D.O. (SOLE OWNER)
(513) 742-1777
Entity
Organization
Contact information
Practice address
289 NORTHLAND BLVD, SUITE A, CINCINNATI, OH 45246-3679
(513) 742-1777
(888) 577-7659
Mailing address
289 NORTHLAND BLVD, SUITE A, CINCINNATI, OH 45246-3679
(513) 742-1777
(888) 577-7659
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
34004608
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0713768
—
OH
01
—
SM0637965
MEDICARE
OH
Enumeration date
10/29/2010
Last updated
10/29/2010
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