Individual
REBECCA R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
550 UNIVERSITY BLVD, INDIANAPOLIS, IN 46202-5149
(317) 948-1310
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-7584
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003562A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/19/2020
Last updated
08/18/2022
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