Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0201X | Gynecologic Oncologist | 04-39969 | KS |
Y | 207VX0201X | Gynecologic Oncologist | 2017014169 | MO |
NPI | 1174835136 |
---|---|
Provider Name | Dr. Blair Smith |
First Address | Kansas City, MO 64132-1110 |
Second Address | Columbus, OH 43210-1267 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2010 |
Last Update Date | 04/01/2022 |