Individual
THOMAS D. SMITH III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1331 MINNICH RD, NEW HAVEN, IN 46774-2051
(260) 373-9600
(260) 373-9602
Mailing address
1234 E DUPONT RD, SUITE 3, FORT WAYNE, IN 46825-1545
(260) 373-9700
(260) 373-9740
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01027868A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000111933
ANTHEM
IN
01
—
00001291560 01
UNITED HEALTHCARE
—
01
—
080130028
RAILROAD MEDICARE
IN
05
—
100053750
—
IN
01
—
1867
PHYSICIANS HEALTH PLAN
IN
01
—
4047064
AETNA
—
Enumeration date
12/29/2005
Last updated
12/14/2009
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