Provider Demographics
NPI:1831805779
Name:SMITH, DAVAUGHN ARNIZE
Entity type:Individual
Prefix:MR
First Name:DAVAUGHN
Middle Name:ARNIZE
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 1:262 BAVARIAN ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-5422
Mailing Address - Country:US
Mailing Address - Phone:513-804-0713
Mailing Address - Fax:
Practice Address - Street 1:262 BAVARIAN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-5422
Practice Address - Country:US
Practice Address - Phone:513-804-0713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant