Provider Demographics
NPI:1770358327
Name:SMITH, DANNY
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:
Last Name:SMITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5230 KY ROUTE 321 STE 6
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-9169
Mailing Address - Country:US
Mailing Address - Phone:606-229-0353
Mailing Address - Fax:
Practice Address - Street 1:1285 ISLAND CREEK RD
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-7223
Practice Address - Country:US
Practice Address - Phone:606-229-0353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker