Provider Demographics
NPI:1437714128
Name:SMITH, AUSTEN M (DO)
Entity Type:Individual
Prefix:
First Name:AUSTEN
Middle Name:M
Last Name:SMITH
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1912 HAYES AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-4736
Mailing Address - Country:US
Mailing Address - Phone:419-557-5541
Mailing Address - Fax:419-557-5542
Practice Address - Street 1:1221 HAYES AVE STE F
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-3345
Practice Address - Country:US
Practice Address - Phone:419-557-6550
Practice Address - Fax:419-621-1047
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-08
Last Update Date:2024-02-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH34.014785207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine