Individual
MRS. KATHLEEN DAWN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2321 S. NATIONAL, SMITH GLYNN CALLAWAY URGENT CARE, SPRINGFIELD, MO 65807
(417) 888-5666
(417) 890-4174
Mailing address
3231 S NATIONAL AVE, URGENT CARE, SPRINGFIELD, MO 65807-7304
(417) 888-5666
(417) 890-4174
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2008004931
MO
363A00000X
Physician Assistant
878
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
431560263
TRICARE WEST
—
01
—
P00653964
RAILROAD MEDICARE
—
Enumeration date
09/30/2005
Last updated
02/03/2010
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