Individual
DR. KENNETH RANDALL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
M2116
TX
207W00000X
Ophthalmology Physician
Primary
MD.29630
AL
207W00000X
Ophthalmology Physician
ME100306
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6360390001
MEDICARE NSC
AL
Enumeration date
03/18/2007
Last updated
05/07/2019
Update your record
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