Individual
KEVIN S SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1930 BISHOP LN, STE 1017, LOUISVILLE, KY 40218-1921
(502) 272-5064
(502) 272-5339
Mailing address
PO BOX 950202, LOUISVILLE, KY 40295-0202
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01051932A
IN
207R00000X
Internal Medicine Physician
036-082153
IL
207R00000X
Internal Medicine Physician
Primary
39134
KY
208M00000X
Hospitalist Physician
39134
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000382064
ANTHEM
—
01
—
049238
SIHO
—
05
—
200156690
—
IN
01
—
214881
MEDICARE GROUP PTAN
IL
05
—
64094048
—
KY
01
—
P00267326
RAILROAD MEDICARE - NICC
KY
01
—
P00272398
RAILROAD MEDICARE - NICC
KY
01
—
P00838098
RAILROAD MEDICARE - NICC
IN
Enumeration date
04/19/2006
Last updated
08/15/2024
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