Provider Demographics
NPI:1346035177
Name:SMITH, JOEL KEVIN
Entity type:Individual
Prefix:MR
First Name:JOEL
Middle Name:KEVIN
Last Name:SMITH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1083 E 174TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44119-3105
Mailing Address - Country:US
Mailing Address - Phone:216-513-2559
Mailing Address - Fax:
Practice Address - Street 1:1083 E 174TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44119-3105
Practice Address - Country:US
Practice Address - Phone:216-513-2559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care