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Organization

CC SMITH MD INC

Active
Other names
Claudet Smith MD
Organization subpart
No

Provider details

NPI number
Authorized official
CLAUDET C SMITH MD (MD)
(419) 621-5780
Entity
Organization

Contact information

Practice address
1200 PROSPECT ST, STE 200, SANDUSKY, OH 44870
(419) 621-5780
(419) 621-5791
Mailing address
1200 PROSPECT ST, STE 200, SANDUSKY, OH 44870
(419) 621-5780
(419) 621-5791

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000322103
ANTHEM BCBS
OH
05
2817643
OH
01
5380
PARAMOUNT
01
7679166
AETNA
01
DB4873
RAILROAD MEDICARE
Enumeration date
09/09/2005
Last updated
06/04/2008
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