Smith, Elton John
Smith, Elton John is an individual health care provider with primary practice located at 4641 Roosevelt Blvd , Phila PA 19124-2343. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Smith, Elton John can be contacted via phone (215) 831-4600.Contact Information
Primary practice address
4641 Roosevelt Blvd
Phila PA 19124-2343
Phone: (215) 831-4600
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 036140146 | Illinois |
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | 0101259244 | Virginia |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | MD425154 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 0101259244 | Virginia |
Profile Details
| NPI number | 1679526784 |
|---|---|
| LBN Legal business name | Smith, Elton John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 18th, 2006 |
| Last updated | Apr 23rd, 2024 - about 8 months 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679526784 | NPPES |
| Pennsylvania | Other | MD425154 | LICENSE NUMBER |
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