Smith, Mark R

Smith, Mark R is an individual health care provider with primary practice located at 1 Childrens Plz , Dayton OH 45404-1815. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Smith, Mark R can be contacted via phone (937) 641-3477.

Contact Information

Primary practice address
1 Childrens Plz Dayton OH 45404-1815
Phone: (937) 641-3477
Fax: (937) 641-5410
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X APRN.CRNA.01284 Ohio

Profile Details

NPI number 1497745285
LBN Legal business name Smith, Mark R
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2005
Last updated Oct 25th, 2021 - about 4 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 1497745285 NPPES
Ohio MEDICAID 0889954

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