Individual
WILLIAM J SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
3700 S 10TH ST, SUITE 1, SEDALIA, MO 65301-2540
(660) 886-7800
(660) 886-3346
Mailing address
512 W MAIN ST, P O BOX 158, COLE CAMP, MO 65325-0158
(660) 668-0851
(660) 668-3041
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
R4P88
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203369715
—
MO
01
—
26387027
BLUE CROSS BLUE SHIELD PIN
MO
Enumeration date
05/27/2005
Last updated
08/25/2021
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