Individual
JAMESY CHARLES SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1103 W LIBERTY ST, FARMINGTON, MO 63640-1921
(573) 756-6751
(573) 756-6807
Mailing address
670 MASON RIDGE CENTER DR, STE 300, SAINT LOUIS, MO 63141-8573
(573) 756-6751
(573) 756-6807
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2009018166
MO
208M00000X
Hospitalist Physician
2009018166
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2009018166
PHYSICIAN LICENSE #
MO
01
—
995324600
BNDD
MO
Enumeration date
06/15/2010
Last updated
03/07/2023
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