Provider Demographics
NPI:1427102953
Name:SMITH, STEVEN G (DC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:G
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45123
Mailing Address - Country:US
Mailing Address - Phone:937-981-7000
Mailing Address - Fax:937-981-7000
Practice Address - Street 1:504 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:OH
Practice Address - Zip Code:45123
Practice Address - Country:US
Practice Address - Phone:937-981-7000
Practice Address - Fax:937-981-7000
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH842111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH31102625300OtherWORKERS COMP
OH0439332Medicaid
OH0439332Medicaid
T47241Medicare UPIN