Individual
PERRY M SMITH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1309 POLK ST, GREAT BEND, KS 67530-3618
(620) 792-5341
(620) 792-3702
Mailing address
1309 POLK ST, GREAT BEND, KS 67530-3618
(620) 792-5341
(620) 792-3702
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-17929
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017892
BLUE SHIELD
KS
Enumeration date
08/09/2005
Last updated
07/08/2007
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