Individual
DR. TYLER K SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
(816) 302-9939
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2017042153
MO
208000000X
Pediatrics Physician
D0068953
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
052206600
—
MD
Enumeration date
03/01/2007
Last updated
03/17/2018
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