Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 35.052323 | OH |
NPI | 1215913736 |
---|---|
Provider Name | Douglas Ronald Smucker |
First Address | Cincinnati, OH 45219-2906 |
Second Address | Cincinnati, OH 45219-2906 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2005 |
Last Update Date | 27/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0636020 | (05) | OH |
A17290 | (02) |