Individual
DR. KENNETH J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8300 CONSTITUTION AVE. NE, PRESBYTERIAN ONCOLOGY KASEMAN HOSPITAL, ALBUQUERQUE, NM 87110-7613
(505) 559-6199
(505) 559-6101
Mailing address
8300 CONSTITUTION AVE. NE, PRESBYTERIAN ONCOLOGY KASEMAN HOSPITAL, ALBUQUERQUE, NM 87110-7613
(505) 559-6199
(505) 559-6101
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
041965
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001419656
—
CT
01
—
010041965CT03
ANTHEM BCBS
CT
01
—
041965
CONNECTICARE
CT
01
—
2V5874
HEALTHNET
—
01
—
P3157657
OXFORD
—
Enumeration date
08/30/2005
Last updated
08/12/2011
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