Provider Demographics
NPI:1679222558
Name:SMITHBAUER, SOPHIA (DO)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:
Last Name:SMITHBAUER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SOPHIA
Other - Middle Name:
Other - Last Name:YANAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1850 E PARK AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-6706
Mailing Address - Country:US
Mailing Address - Phone:814-235-2480
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-531-8521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-20
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program