Provider Demographics
NPI:1386100741
Name:SMITH, ALLAN C
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:C
Last Name:SMITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 GLENSPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-2317
Mailing Address - Country:US
Mailing Address - Phone:513-771-9600
Mailing Address - Fax:513-771-2546
Practice Address - Street 1:415 GLENSPRINGS DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-2317
Practice Address - Country:US
Practice Address - Phone:513-771-9600
Practice Address - Fax:513-771-2546
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty