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Organization

GREGORY D. SMITH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GREGORY D. SMITH MD (OWNER)
(270) 765-5926
Entity
Organization

Contact information

Practice address
2412 RING RD STE 200, ELIZABETHTOWN, KY 42701-5913
(270) 765-5926
(270) 763-0051
Mailing address
53 MAYAPPLE LN, ELIZABETHTOWN, KY 42701-8944
(270) 765-5926
(270) 763-0051

Taxonomy

Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
38746
KY
363LF0000X
Family Nurse Practitioner
3007523
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64087711
KY
Enumeration date
09/24/2008
Last updated
10/21/2014
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