Provider Demographics
NPI:1952426751
Name:SMOOKE, JOEL E (DC)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:E
Last Name:SMOOKE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4316 SALINE ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2912
Mailing Address - Country:US
Mailing Address - Phone:412-422-9369
Mailing Address - Fax:412-422-2896
Practice Address - Street 1:1154 GREENFIELD AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-2958
Practice Address - Country:US
Practice Address - Phone:412-422-4321
Practice Address - Fax:412-422-2896
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2022-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-004209-L111NS0005X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1209146Medicaid
PA1042090Medicaid
PA1042090Medicaid
PA608779Medicare ID - Type Unspecified