Provider Demographics
NPI:1780706069
Name:SMITH, HUGH SANFORD (PHD)
Entity type:Individual
Prefix:DR
First Name:HUGH
Middle Name:SANFORD
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1834 OREGON PIKE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6463
Mailing Address - Country:US
Mailing Address - Phone:717-391-6808
Mailing Address - Fax:717-391-0709
Practice Address - Street 1:1834 OREGON PIKE
Practice Address - Street 2:SUITE 4
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6463
Practice Address - Country:US
Practice Address - Phone:717-391-6808
Practice Address - Fax:717-391-0709
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2016-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-008355-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001638687Medicaid