Individual
KENT SMILLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
787 37TH ST STE E200, VERO BEACH, FL 32960-7306
(772) 978-7808
(772) 978-9320
Mailing address
787 37TH ST STE E200, VERO BEACH, FL 32960-7306
(772) 978-7808
(772) 978-9320
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101249094
VA
207X00000X
Orthopaedic Surgery Physician
01068319A
IN
207X00000X
Orthopaedic Surgery Physician
MD00042627
WA
207X00000X
Orthopaedic Surgery Physician
MD20796
ME
207X00000X
Orthopaedic Surgery Physician
Primary
ME130147
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000668941
ANTHEM PROVIDER NUMBER
IN
01
—
0176932
LABOR & INDUSTRIES
WA
05
—
019183400
—
FL
05
—
200985030
—
IN
05
—
247586
—
OR
05
—
8379323
—
WA
01
—
88545M
REGENCE
WA
01
—
8931559
CRIME VICTIMS
WA
Enumeration date
02/20/2007
Last updated
08/10/2022
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