Provider Demographics
NPI:1932193380
Name:SMOKER, CHAD E (MD)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:E
Last Name:SMOKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 834
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46527-0834
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:68370 CLINTON ST
Practice Address - Street 2:
Practice Address - City:NEW PARIS
Practice Address - State:IN
Practice Address - Zip Code:46553-9235
Practice Address - Country:US
Practice Address - Phone:574-831-5440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01054538B207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89134J1Medicaid
H42697Medicare UPIN
2016557Medicare ID - Type Unspecified