Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 40756 | KY |
Y | 207X00000X | Orthopaedic Surgeon | 40756 | KY |
NPI | 1356474597 |
---|---|
Provider Name | Dr. James Steve Smith |
First Address | Louisville, KY 40207-4713 |
Second Address | Louisville, KY 40207-4713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 15/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000528860 | ANTHEM (01) | KY |
7100018340 | (05) | KY |