Organization
SMITH IMAGING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH D SMITH MD (PRESIDENT)
(573) 760-8075
Entity
Organization
Contact information
Practice address
1101 W LIBERTY, PARKLAND HEALTH CENTER, FARMINGTON, MO 63640
(573) 760-8075
(573) 760-8358
Mailing address
PO BOX 629, SMITH IMAGING INC, FARMINGTON, MO 63640
(573) 760-8075
(314) 821-2180
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14989V14989
GHP
MO
01
—
8707
HEALTHCARE USA
MO
01
—
945K1
BCBS
MO
01
—
STL1600408
UHC
MO
Enumeration date
08/09/2006
Last updated
08/22/2020
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