Individual
DR. BRUCE C SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
423 W CLAY ST, CLINTON, KY 42031-1305
(270) 653-0220
(270) 653-0221
Mailing address
423 W CLAY ST, CLINTON, KY 42031-1305
(270) 653-0220
(270) 653-0221
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17274
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000333811
ANTHEM
KY
05
—
64172745
—
KY
Enumeration date
07/07/2005
Last updated
07/08/2007
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