Provider Demographics
NPI:1881668176
Name:SMITH, ERIK JON (DO)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:JON
Last Name:SMITH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 MOUNT ROSE AVE
Mailing Address - Street 2:SUITE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3026
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-3127
Practice Address - Street 1:35 MONUMENT RD
Practice Address - Street 2:SUITE 202
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5074
Practice Address - Country:US
Practice Address - Phone:717-851-2722
Practice Address - Fax:717-851-3127
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013630207VM0101X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101530962Medicaid
PA30110960OtherAMERIHEALTH MERCY - WMG
PA30131819OtherAMERIHEALTH MERCY - WMG
PA719713OtherUPMC
PA30110801OtherAMERIHEALTH MERCY - YH
PA1819058OtherHIGHMARK BLUE SHIELD
MD048723600Medicaid
PA1549231OtherGATEWAY
PA30136937OtherAMERIHEALTH MERCY-YHOBGYN
PA30131819OtherAMERIHEALTH MERCY - WMG
PA101530962Medicaid
PA100009EZ3Medicare PIN