Provider Demographics
NPI:1588362420
Name:SMILEY, DWYTE
Entity type:Individual
Prefix:
First Name:DWYTE
Middle Name:
Last Name:SMILEY
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 1:130 BRANDYWINE DR APT 5
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-1378
Mailing Address - Country:US
Mailing Address - Phone:330-554-7532
Mailing Address - Fax:
Practice Address - Street 1:5982 RHODES RD
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-8100
Practice Address - Country:US
Practice Address - Phone:800-673-1347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty