Individual
BENJAMIN LEVI SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1408 EAST ST, IOLA, KS 66749-4402
(620) 365-3115
Mailing address
1408 EAST ST, IOLA, KS 66749-4402
(620) 363-4748
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53-78768-051
KS
Other
Enumeration date
06/26/2019
Last updated
06/26/2019
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