Provider Demographics
NPI:1639314164
Name:SMITH, DOUGLAS MACARTHUR JR (APRN-CNP)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:MACARTHUR
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:APRN-CNP
Other - Prefix:
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Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-3196
Mailing Address - Fax:614-293-4812
Practice Address - Street 1:460 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1240
Practice Address - Country:US
Practice Address - Phone:614-293-3196
Practice Address - Fax:614-293-4812
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHCOA 09750 NP363LA2200X
OHCOA-NS09649364SA2200X
OHAPRN.CNP.09750363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health