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Individual

JORDAN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2301 HOLMES ST, KANSAS CITY, MO 64108-2640
(816) 404-4862
(816) 404-9480
Mailing address
2301 ERWIN RD, DURHAM, NC 27705-4699
(919) 620-4855

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2020-00492
NC
390200000X
Student in an Organized Health Care Education/Training Program
2015017247
MO

Other

Enumeration date
04/08/2015
Last updated
06/25/2020
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