Individual
DR. GREG N SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3900 KRESGE WAY, STE 56, LOUISVILLE, KY 40207-4683
(812) 248-4789
(812) 248-4773
Mailing address
2700 STANLEY GAULT PKWY, STE 129, LOUISVILLE, KY 40223-5176
(502) 253-4917
(502) 489-5751
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
25764
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000046155
ANTHEM
KY
05
—
100373840
—
IN
01
—
1049112
PASSPORT
KY
01
—
130006170
MEDICARE ID
—
01
—
2432393000
PASSPORT ADVANTAGE
KY
05
—
64257645
—
KY
Enumeration date
12/29/2005
Last updated
12/02/2020
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