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Individual

REBECCA L SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
211 SAINT FRANCIS DR, SUITE 15, CAPE GIRARDEAU, MO 63703-5049
(573) 331-3333
(573) 331-3334
Mailing address
PO BOX 801143, KANSAS CITY, MO 64180-1143
(573) 331-5583
(573) 331-5079

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
2012007485
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060068688
MEDICARE RAILROAD
OK
05
100043380A
OK
05
1083684583
IL
05
7100196110
KY
01
OK700125
MEDICARE PTAN
OK
01
P00611418
MEDICARE RAILROAD
OK
01
P01036441
RR MEDICARE
MO
Enumeration date
01/25/2006
Last updated
02/25/2021
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