Smoketown Family Wellness Center Corp

NPI #1184145815 in Louisville, Kentucky

Provider Information

NPI Number: 1184145815
Entity Type: Organization
Organization Name: Smoketown Family Wellness Center Corp
Primary Specialty: Pediatrics
Enumeration Date: Jul 3, 2017
Last Updated: Oct 10, 2023

Practice Location

Address: 760 S HANCOCK ST APT B100
City: Louisville
State: Kentucky
ZIP Code: 40203-2449
Phone: (502) 242-7458

Authorized Official

Name: DR. CHARLOTTE GAY STITES, MD
Title: PHYSICIAN OWNER
Phone: (502) 242-7458

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
Nurse Practitioner - Pediatrics — Pediatrics	363LP0200X
Pediatrics	208000000X	Primary

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