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Individual

DR. BLAKE ALLEN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3113 BELLEVUE AVE FL 3, CINCINNATI, OH 45219-3158
(513) 475-8730
(513) 475-8033
Mailing address
3113 BELLEVUE AVE FL 3, CINCINNATI, OH 45219-3158
(513) 475-8730
(513) 475-8033

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
01073180A
IN
2084N0400X
Neurology Physician
Primary
35121619
OH
2084N0400X
Neurology Physician
46546
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0104892
OH
05
7100305370
KY
01
P01347060
RR MEDICARE
Enumeration date
05/19/2009
Last updated
11/08/2023
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