Khercie Smith, MD | |
56 Marie Langdon Dr, Manchester, KY 40962-6329 | |
(606) 599-4080 | |
Not Available |
Full Name | Khercie Smith |
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Gender | Female |
Speciality | Pediatrics |
Location | 56 Marie Langdon Dr, Manchester, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1629563747 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 4301116055 (Michigan) | Primary |
Entity Name | Memorial Hospital, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1831150119 PECOS PAC ID: 4486616141 Enrollment ID: O20041103001183 |
Entity Name | Memorial Hospital, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558665752 PECOS PAC ID: 4486616141 Enrollment ID: O20141202002193 |
Entity Name | Memorial Hospital, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1255471827 PECOS PAC ID: 4486616141 Enrollment ID: O20141210002155 |
Entity Name | Memorial Hospital, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881112134 PECOS PAC ID: 4486616141 Enrollment ID: O20180529001421 |
Mailing Address | Practice Location Address |
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Khercie Smith, MD 330 Barclay Ave Ne, Grand Rapids, MI 49503-2556 Ph: () - | Khercie Smith, MD 56 Marie Langdon Dr, Manchester, KY 40962-6329 Ph: (606) 599-4080 |
Ashtin Danielle Nix, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 56 Marie Langdon Dr, Manchester, KY 40962 Phone: 606-599-4080 Fax: 606-598-1688 |