Provider Demographics
NPI:1104989599
Name:ANDREW T. SMITH,M.D., P.C.
Entity type:Organization
Organization Name:ANDREW T. SMITH,M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-859-5844
Mailing Address - Street 1:835 BELVIDERE RD
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1384
Mailing Address - Country:US
Mailing Address - Phone:908-859-5844
Mailing Address - Fax:908-859-6357
Practice Address - Street 1:835 BELVIDERE RD
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1384
Practice Address - Country:US
Practice Address - Phone:908-859-5844
Practice Address - Fax:908-859-6357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA066186174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1085642OtherHORIZON NJ HEALTH
NJ1744588OtherUNITED HEALTHCARE
PA959505OtherBCBS OF PA
PA0017730280001Medicaid
PA959505OtherHIGHMARK BCBS
NJ=========OtherMULTIPLAN
NJ1085642OtherHORIZON NJ HEALTH
NJ=========OtherHEALTH PAYORS COALITION
NJ=========OtherAETNA
NJ1744588OtherUNITED HEALTHCARE
PA0017730280001Medicaid
PA959505OtherHIGHMARK BCBS
NJ=========OtherCONSUMER HEALTH NETWORK
PA052459Medicare ID - Type Unspecified
PA0017730280001Medicaid