Provider Demographics
NPI:1780257550
Name:SMITH, KASDEN SAWYER
Entity type:Individual
Prefix:
First Name:KASDEN
Middle Name:SAWYER
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 1:11857 SANDHILL RD
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT
Mailing Address - State:WV
Mailing Address - Zip Code:25550-4371
Mailing Address - Country:US
Mailing Address - Phone:304-593-4368
Mailing Address - Fax:
Practice Address - Street 1:11857 SANDHILL RD
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT
Practice Address - State:WV
Practice Address - Zip Code:25550-4371
Practice Address - Country:US
Practice Address - Phone:304-593-4368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant