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Individual
DR. KYLE P SMITH
Active
Individual
DR. KYLE P SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
118405
MO
207Q00000X
Family Medicine Physician
Primary
K4570
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123528
MO BLUE SHIELD
MO
05
—
143532003
—
AR
05
—
244010914
—
MO
01
—
98348
ARK BLUE SHIELD
AR
Enumeration date
02/07/2007
Last updated
08/29/2022
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