Organization
KENNETH R SMITH MD PLLC
Active
Organization
KENNETH R SMITH MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH R SMITH MD (OWNER)
(502) 429-3937
Entity
Organization
Contact information
Practice address
9700 PARK PLAZA AVE UNIT 103, LOUISVILLE, KY 40241-2286
(502) 429-3937
(502) 429-3996
Mailing address
9700 PARK PLAZA AVE UNIT 103, LOUISVILLE, KY 40241-2286
(502) 429-3937
(502) 429-3996
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC1334
RAILROAD MEDICARE
KY
Enumeration date
08/19/2006
Last updated
07/13/2010
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