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Individual

JIMMY SHAUN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
800 ROSE STREET, G100 GILL HEART INSTITUTE, LEXINGTON, KY 40536
(859) 323-0295
(859) 323-1256
Mailing address
700 ACKERMAN RD STE 570, COLUMBUS, OH 43202-1579
(614) 293-4925

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
02968
KY
207R00000X
Internal Medicine Physician
TP048
KY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
02968
KY
207RP1001X
Pulmonary Disease Physician
02968
KY
207RP1001X
Pulmonary Disease Physician
34009306
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201032990
IN
05
64121767
KY
05
PENDING
OH
Enumeration date
05/16/2006
Last updated
01/22/2021
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