Individual
KHANNAH MARLITT-MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
189 IOWA BLVD, TRENTON, MO 64683-8343
(660) 358-5750
Mailing address
189 IOWA BLVD, TRENTON, MO 64683-8343
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2019005173
MO
207R00000X
Internal Medicine Physician
2019005173
MO
Other
Enumeration date
05/06/2013
Last updated
02/18/2025
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