Individual
JODI MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-7498
Mailing address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-7498
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2008002474
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689875106
—
MO
01
—
P00758029
RAILROAD MEDICARE
MO
01
—
P01317677
RAILROAD MEDICARE
MO
Enumeration date
05/31/2007
Last updated
12/16/2022
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