| Doctor Name: | JOHN SMITH |
| NPI Number: | 1033103734 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 35056121S |
| Business Practice Address: | 1101 Decatur St Sandusky, OH - 448703335 |
| Business Phone Number: | 4196267400 |
| Business Fax Number: | |
| Mailing Address: | 2203 Eagles Nest Cir, SANDUSKY |
| State: | OH |
| Postal Code: | 448707024 |
| Phone Number: | 4196251343 |
| Fax Number: | |
| NPI Enumeration Date: | 09/08/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207PE0004X |
| License Number: | 35056121S |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Emergency Medicine |
| Taxonomy Specialization: | Emergency Medical Services |
| Taxonomy Definition: | An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |