Individual
JARED B SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19550 E 39TH ST S, STE 325, INDEPENDENCE, MO 64057-2303
(816) 373-4646
(816) 373-7831
Mailing address
19550 E 39TH ST S, STE 325, INDEPENDENCE, MO 64057-2303
(816) 373-4646
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2007007789
MO
390200000X
Student in an Organized Health Care Education/Training Program
TL-308
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207308305
—
MO
01
—
250766
HEALTHLINK
—
01
—
P00453853
RAILROAD MEDICARE
—
Enumeration date
01/26/2007
Last updated
07/10/2024
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