Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 0423020 | KS |
NPI | 1154372670 |
---|---|
Provider Name | David M Smith |
First Address | Overland Park, KS 66211-1366 |
Second Address | Overland Park, KS 66211-1366 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 22/07/2013 |