Individual
DR. CAROLYN ANNE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13303 TESSON FERRY RD STE 150, SAINT LOUIS, MO 63128
(314) 842-5239
(314) 842-3835
Mailing address
PO BOX 23340, SAINT LOUIS, MO 63156-3340
(314) 851-1000
(314) 851-4445
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2003010764
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208819607
—
MO
05
—
ENROLLED
—
IL
Enumeration date
07/17/2006
Last updated
03/15/2019
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