| Doctor Name: | MR. KENNETH A SMITH |
| NPI Number: | 1003907304 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 01022346 |
| Business Practice Address: | 1234 East Dupont Road Suite 5 Fort Wayne, IN - 46825 |
| Business Phone Number: | 2604891666 |
| Business Fax Number: | 2604893255 |
| Mailing Address: | 1234 East Dupont Road, Suite 1 FORT WAYNE |
| State: | IN |
| Postal Code: | 46825 |
| Phone Number: | 2603739728 |
| Fax Number: | 2604595664 |
| NPI Enumeration Date: | 09/28/2006 |
| NPI Last Update Date: | 08/03/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RR0500X |
| License Number: | 01022346 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Rheumatology |
| Taxonomy Definition: | An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |