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Individual
KRYSTAL S SMITH
Active
Individual
KRYSTAL S SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
T-2246
MS
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MDDO1578
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05409055
—
MS
01
—
P01590545
RAILROAD MEDICARE
MS
Enumeration date
07/08/2009
Last updated
03/08/2021
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