Individual
JACQUELINE J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2521 GLENN HENDREN DR, SUITE 402, LIBERTY, MO 64068
(816) 781-8445
(816) 781-8413
Mailing address
2521 GLENN HENDREN DR, SUITE 402, LIBERTY, MO 64068-3388
(816) 781-8445
(816) 781-8413
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MD118130
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204660609
—
MO
01
—
5177783
BCBS
MO
Enumeration date
01/16/2006
Last updated
08/21/2018
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