Individual
KENNETH GEORGE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
26 APPLE VALLEY ROAD, HIGH ROLLS, NM 88325
(575) 632-1134
Mailing address
PO BOX 442, HIGH ROLLS MOUNTAIN PARK, NM 88325-0442
(575) 682-1134
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
73-70
NM
Other
Enumeration date
05/09/2019
Last updated
05/09/2019
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