Individual
KEVIN B. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14377 WOODLAKE DR, SUITE 300, CHESTERFIELD, MO 63017-5735
(314) 434-3333
(314) 434-6247
Mailing address
14377 WOODLAKE DR, SUITE 300, CHESTERFIELD, MO 63017-5735
(314) 434-3333
(314) 434-6247
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R7502
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080115894
RAILROAD MEDICARE
MO
Enumeration date
03/14/2006
Last updated
08/19/2014
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