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Audrey Renee Smith

Family Medicine

Allopathic & Osteopathic Physicians

1101 Saint Christopher Dr Ste 250, Ashland, KY 41101-7088

PECOS Enrollment

This provider is enrolled in PECOS as AUDREY SMITH.

Based on the most recent information from CMS, provider Audrey Renee Smith is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 8 days ago.

Profile Details

Provider ID
1538514567
Provider Type
Individual
Full Name
Smith, Audrey Renee
Credential
DO

Gender
Female
Sole Proprietor
No
Enumeration Date
4/27/2016
Last Updated
6/3/2019

Contact Information

Practice Location

1101 Saint Christopher Dr Ste 250, Ashland, KY 41101-7088

(606) 836-3196

(606) 836-2564

Mailing Location

1101 Saint Christopher Dr Ste 250, Ashland, KY 41101-7088

(606) 836-3196

(606) 836-2564

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 04496 Kentucky
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Audrey Renee Smith

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Ledford Family Care

Ashland Hospital Coporation

Mcdaniel, Mark Elliott

Detherage, James M

Dickess, Kristie

Kazee, Jackie R

Murphy, Kristen Nicole

Ashland Family Medicine

Ashland Hospital Corporation

Walz, Jon H.