Individual
KENNETH SANDERS SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12639 OLD TESSON RD STE 115, SAINT LOUIS, MO 63128-2786
(314) 849-0311
Mailing address
12639 OLD TESSON RD STE 115, SAINT LOUIS, MO 63128-2786
(314) 849-0311
(314) 849-4423
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2019013302
MO
207X00000X
Orthopaedic Surgery Physician
DR.0060799
CO
Other
Enumeration date
05/08/2013
Last updated
08/19/2025
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