Individual
DOUGLAS D SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
206 N BISMARK ST, SUITE A, CONCORDIA, MO 64020-8180
(660) 463-0234
(660) 463-0266
Mailing address
8027 STRAWBERRY HILL RD, ODESSA, MO 64076-5399
(816) 633-4199
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R9H22
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010568509
—
MO
01
—
14109017
BCBS
—
01
—
14109027
BCBS
—
01
—
14109077
BCBS
—
05
—
202545364
—
MO
05
—
540568508
—
MO
05
—
595956103
—
MO
05
—
599225901
—
MO
Enumeration date
04/25/2006
Last updated
10/12/2016
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