Individual
JOE MICHAEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
150 N EAGLE CREEK DR, LEXINGTON, KY 40509-1805
(859) 967-5715
Mailing address
3320 TATES CREEK RD, SUITE 204, LEXINGTON, KY 40502-3400
(859) 268-1030
(859) 269-4120
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1670A
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74325481
—
KY
Enumeration date
01/19/2007
Last updated
07/08/2007
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