# SMITH STREET MEDICAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326111253
- **Authorized official:** MRS. MICHELE LILLIAN STONE (ADMINISTRATOR)
- **Authorized official phone:** (573) 471-0200

## Contact information

- **Practice address:** 117 SMITH STREET, SIKESTON, MO 63801
- **Practice address phone:** (573) 471-7550
- **Practice address fax:** (573) 471-7559
- **Mailing address:** 117 SMITH STREET, SIKESTON, MO 63801
- **Mailing address phone:** (573) 471-7550
- **Mailing address fax:** (573) 471-7559

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 37010 | MO | Yes |

## Other

- **Enumeration date:** 11/16/2006
- **Last updated:** 01/28/2008