Basic Information
| Provider Information | |||||||||
| NPI: | 1881866432 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SMART | ||||||||
| FirstName: | LUKE | ||||||||
| MiddleName: | RUSSELL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3333 BURNET AVENUE | ||||||||
| Address2: | MLC 6015 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452293026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136364266 | ||||||||
| FaxNumber: | 5136363549 | ||||||||
| Practice Location | |||||||||
| Address1: | 3333 BURNET AVE # MLC6015 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452293026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136364266 | ||||||||
| FaxNumber: | 5136363549 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2008 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 258675 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0000X | 127807 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | 208000000X | 258675 | NY | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0207X | 127807 | OH | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Hematology-Oncology | 208000000X | 35.127807 | OH | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.