Individual
DR. BRAD V. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3801 S. NATIONAL AVE, 5TH FLOOR, SPRINGFIELD, MO 65807-5210
(417) 269-7728
(417) 269-7729
Mailing address
PO BOX 4046, #540, SPRINGFIELD, MO 65808-4046
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
18409
OK
207R00000X
Internal Medicine Physician
Primary
2006024382
MO
207R00000X
Internal Medicine Physician
E-3423
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148194001
—
AR
05
—
203628904
—
MO
01
—
211845
BLUE CROSS OF MO
—
Enumeration date
08/05/2006
Last updated
01/21/2013
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