Provider Demographics
NPI:1083623813
Name:THE SMOKING CESSATION & WEIGHT REDUCTION CLINIC
Entity Type:Organization
Organization Name:THE SMOKING CESSATION & WEIGHT REDUCTION CLINIC
Other - Org Name:OXYGEN DIRECT
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:DOTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-647-0976
Mailing Address - Street 1:7000 HOUSTON RD
Mailing Address - Street 2:SUITE 48
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-4873
Mailing Address - Country:US
Mailing Address - Phone:859-647-0976
Mailing Address - Fax:859-647-1309
Practice Address - Street 1:7000 HOUSTON RD
Practice Address - Street 2:SUITE 48
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-4873
Practice Address - Country:US
Practice Address - Phone:859-647-0976
Practice Address - Fax:859-647-1309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY38121173000000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies