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Individual

SHADRACH J SMITH JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12140 NALL AVE, SUITE 100, OVERLAND PARK, KS 66209
(913) 451-8500
(913) 451-1754
Mailing address
12140 NALL AVE, SUITE 100, OVERLAND PARK, KS 66209
(913) 451-8500
(913) 451-1754

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2000174361
MO

Other

Enumeration date
04/19/2006
Last updated
07/24/2013
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