Basic Information
Provider Information
NPI: 1871502773
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SMITH
FirstName: RONALD
MiddleName: ENGLISH
NamePrefix: DR.
NameSuffix: JR.
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 813 GOBIN DR
Address2:  
City: CARLISLE
State: PA
PostalCode: 170131514
CountryCode: US
TelephoneNumber: 7172498951
FaxNumber: 7172453815
Practice Location
Address1: 450 GIBNER RD STE 1
Address2: CARLISLE BARRACKS
City: CARLISLE
State: PA
PostalCode: 170135086
CountryCode: US
TelephoneNumber: 7172453041
FaxNumber: 7172453815
Other Information
ProviderEnumerationDate: 08/07/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X6819MTY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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