Individual
DENNIS L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1600 N MORLEY ST STE A120, MOBERLY, MO 65270-3685
(660) 372-9595
(660) 372-9696
Mailing address
PO BOX 551, HANNIBAL, MO 63401-0551
(573) 248-1300
(573) 248-5264
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2010077923
MO
207P00000X
Emergency Medicine Physician
36753-021
WI
207Q00000X
Family Medicine Physician
Primary
2010077923
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114292880
—
MI
05
—
1952331910
—
MO
05
—
30085400
—
WI
01
—
930111565
MEDICARE RAILROAD
WI
01
—
MA5092007
MEDICARE
MO
Enumeration date
07/04/2006
Last updated
02/06/2023
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