Individual
PAUL E SMITH III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1550 HIGHWAY 15 S STE 200, JACKSON, KY 41339-0714
(606) 666-8404
Mailing address
6 FONTAINE BLVD, WINCHESTER, KY 40391-9216
(231) 742-1213
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
03402
KY
207QA0401X
Addiction Medicine (Family Medicine) Physician
03402
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114947926
—
MI
05
—
7100177400
—
KY
01
—
PS012921
BLUE CROSS
MI
Enumeration date
05/26/2006
Last updated
07/21/2022
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