Individual
DR. RAY C SMITH III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1606 N 7TH ST, TERRE HAUTE, IN 47804-2706
(812) 442-2500
Mailing address
250 N SHADELAND AVE, SUITE 130 - PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
(317) 547-5345
(317) 962-4343
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01033441A
IN
207P00000X
Emergency Medicine Physician
4301042616
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100388340
—
IN
01
—
930040138
RAILROAD MEDICARE
IN
Enumeration date
07/17/2006
Last updated
01/23/2017
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