Provider Demographics
NPI:1174502116
Name:SMITH, GREGORY L (MD)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:L
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8851 SOUTHPOINTE DR
Mailing Address - Street 2:C-1
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-0975
Mailing Address - Country:US
Mailing Address - Phone:317-887-3344
Mailing Address - Fax:317-885-5018
Practice Address - Street 1:8851 SOUTHPOINTE DR
Practice Address - Street 2:C-1
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-0975
Practice Address - Country:US
Practice Address - Phone:317-887-3344
Practice Address - Fax:317-885-5018
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01037851208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics