Provider Demographics
NPI:1487758983
Name:SCHEEN & SMITH, P.S.C.
Entity type:Organization
Organization Name:SCHEEN & SMITH, P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:Z
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-896-8803
Mailing Address - Street 1:3950 KRESGE WAY
Mailing Address - Street 2:SUITE 305
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4637
Mailing Address - Country:US
Mailing Address - Phone:502-896-8803
Mailing Address - Fax:502-896-8863
Practice Address - Street 1:3950 KRESGE WAY
Practice Address - Street 2:SUITE 305
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4637
Practice Address - Country:US
Practice Address - Phone:502-896-8803
Practice Address - Fax:502-896-8863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY17338207ND0900X, 207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Multi-Specialty
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64173388Medicaid
KY000000046994OtherBCBS
KY1066659OtherPASSPORT
KY2434641000OtherPASSPORT ADVANTAGE
KYCB7118OtherRAILROAD MEDICARE
KY1382Medicare ID - Type Unspecified
KY64173388Medicaid