Provider Demographics
NPI:1144489626
Name:ROBERT J. SMYTH, M.D., INC.
Entity type:Organization
Organization Name:ROBERT J. SMYTH, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:SMYTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-321-2211
Mailing Address - Street 1:2730 OBSERVATORY AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-2108
Mailing Address - Country:US
Mailing Address - Phone:513-321-2211
Mailing Address - Fax:513-321-0700
Practice Address - Street 1:2730 OBSERVATORY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-2108
Practice Address - Country:US
Practice Address - Phone:513-321-2211
Practice Address - Fax:513-321-0700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH37770174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0428531Medicaid
OH0428531Medicaid
OHSM0404453Medicare PIN