Provider Demographics
NPI:1619023405
Name:SMITH, ADAM C
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:C
Last Name:SMITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9341 OLIVER KNOLL CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-9217
Mailing Address - Country:US
Mailing Address - Phone:513-874-8414
Mailing Address - Fax:
Practice Address - Street 1:9341 OLIVER KNOLL CT
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-9217
Practice Address - Country:US
Practice Address - Phone:513-874-4814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide