Individual
DWAYNE V SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4900 HOUSTON RD, FLORENCE, KY 41042-4824
(859) 212-4625
(859) 212-4638
Mailing address
4900 HOUSTON RD, FLORENCE, KY 41042-4824
(859) 212-4625
(859) 212-4638
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
23626
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020049483
RAILROAD MEDICARE
KY
05
—
200347010A
—
IN
05
—
2626582
—
OH
05
—
64236268
—
KY
01
—
P01134522
RR MEDICARE
KY
Enumeration date
08/22/2005
Last updated
09/30/2015
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