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Individual

CAMERON LEE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
4320 WORNALL ROAD, SUITE 65, KANSAS CITY, MO 64111
(816) 932-6100
(816) 932-9002
Mailing address
901 E. 104TH ST., MAILSTOP 400N, KANSAS CITY, MO 64131-9712
(816) 502-7104
(816) 932-9670

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036172557
IL
207R00000X
Internal Medicine Physician
05-42006
KS
207R00000X
Internal Medicine Physician
Primary
2010031553
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
W19000148
MEDICARE PTAN
MO
Enumeration date
01/25/2009
Last updated
11/11/2024
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