Provider Demographics
NPI:1154827335
Name:SMITH, KATIE ALISON (DO)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:ALISON
Last Name:SMITH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 PARRISH ST
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1731
Mailing Address - Country:US
Mailing Address - Phone:585-396-6000
Mailing Address - Fax:
Practice Address - Street 1:335 PARRISH ST
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1728
Practice Address - Country:US
Practice Address - Phone:585-393-2888
Practice Address - Fax:585-919-2539
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309714207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine