Individual
BRIAN A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
460 WILSON AVE, FIRST FLOOR, VERSAILLES, KY 40383-1947
(859) 879-0111
(859) 879-0363
Mailing address
460 WILSON AVE, FIRST FLOOR, VERSAILLES, KY 40383-1947
(859) 879-0111
(859) 879-0363
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
40454
KY
207Q00000X
Family Medicine Physician
Primary
40454
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100003320
—
KY
Enumeration date
06/15/2006
Last updated
06/09/2022
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