Neal T. Smith & Jeannine L. Dolan, M.D.'S

Key facts

NPI

1205923232

Entity type

Organization (NPI type 2)

Primary specialty

Family Medicine Physician 207Q00000X

Legal business name

NEAL T. SMITH & JEANNINE L. DOLAN, M.D.'S

Practice address

5973 Walworth Road
Ontario, NY 14519

Phone

(315) 524-2881

Fax

(315) 524-2231

NPI assigned

Oct 10, 2006

Organization subpart

No

Authorized official

Name

Dr. Neal T. Smith, M.D.

Title

Partner

Phone

(315) 524-2881

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James F Stohr, R.P.A. Physician Assistant · Williamson, NY · NPI 1396832325
  NPD (past)
• Ericka Lynn Berger, MD Family Medicine Physician · Ephrata, PA · NPI 1942251871
  NPD (past) FAMILY MEDICINE

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 30, 2020.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1205923232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 368",
            "city": "ONTARIO",
            "state": "NY",
            "postal_code": "14519",
            "telephone_number": "315-524-2881",
            "fax_number": "315-524-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5973 WALWORTH ROAD",
            "city": "ONTARIO",
            "state": "NY",
            "postal_code": "14519",
            "telephone_number": "315-524-2881",
            "fax_number": "315-524-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEAL T. SMITH & JEANNINE L. DOLAN, M.D.'S",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "NEAL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "315-524-2881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN (PIN)",
            "identifier": "CF6398",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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