Individual
MICHAEL THOMAS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNP
Contact information
Practice address
1805 27TH ST, PORTSMOUTH, OH 45662-2686
(740) 356-6891
(740) 356-1280
Mailing address
1735 27TH ST STE B06, PORTSMOUTH, OH 45662-2681
(740) 356-6891
(740) 356-1280
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
COA.15732-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0100828
—
OH
05
—
7100283180
—
KY
Enumeration date
03/21/2014
Last updated
05/05/2023
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