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Individual

DR. KELLIE K SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
9050 MONTGOMERY ROAD, SUITE B, CINCINNATI, OH 45242-7740
(513) 631-6963
(513) 631-1970
Mailing address
9050 MONTGOMERY ROAD, SUITE B, CINCINNATI, OH 45242-7740
(513) 631-6963
(513) 631-1970

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35065777
OH
208M00000X
Hospitalist Physician
35065777
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0996052
OH
01
P00790119
RAILROAD MEDICARE PIN
OH
Enumeration date
04/12/2006
Last updated
06/30/2015
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