Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 35136469 | OH |
NPI | 1588005763 |
---|---|
Provider Name | Scott W Smith |
First Address | Gahanna, OH 43230-6884 |
Second Address | Gahanna, OH 43230-6884 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2013 |
Last Update Date | 06/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0373800 | (05) | OH |