Smith, David Allen

Smith, David Allen is an sole proprietor health care provider with primary practice located at 7613 W Jefferson Blvd Ste 200 , Fort Wayne IN 46804-4182. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Pediatric Surgery. Allopathic & Osteopathic Physicians / Pediatric Surgery is his primary health care specialty. Smith, David Allen can be contacted via phone (260) 469-7337.

Contact Information

Primary practice address
7613 W Jefferson Blvd Ste 200 Fort Wayne IN 46804-4182
Phone: (260) 469-7337
Fax: (260) 469-7340
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 01040403A Indiana
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X 01040403A Indiana

Profile Details

NPI number 1962405993
LBN Legal business name Smith, David Allen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 23rd, 2005
Last updated Mar 31st, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962405993 NPPES
Ohio MEDICAID 2080877
Ohio MEDICAID 104683309
Ohio MEDICAID 200049180

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