Organization
VERSAILLES FAMILY MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN A SMITH MD (OWNER)
(859) 879-0111
Entity
Organization
Contact information
Practice address
460 WILSON AVE, FIRST FLOOR, VERSAILLES, KY 40383-1947
(859) 879-0111
(859) 879-0363
Mailing address
460 WILSON AVE, FIRST FLOOR, VERSAILLES, KY 40383-1947
(859) 879-0111
(859) 879-0363
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40454
KY
207Q00000X
Family Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
01/28/2007
Last updated
05/19/2022
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