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Individual

BARRY JOE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
12345 W BEND DR, SUITE 201, SAINT LOUIS, MO 63128-2182
(314) 722-2530
(314) 722-2534
Mailing address
PO BOX 822344, PHILADELPHIA, PA 19182-2344
(314) 308-2799
(908) 653-9305

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
116656
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
116656
MEDICAL LICENSE
MO
Enumeration date
03/06/2007
Last updated
03/26/2014
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