Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 04-31950 | KS |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 04-31950 | KS |
NPI | 1174599732 |
---|---|
Provider Name | Dr. Todd B Smith |
First Address | Olathe, KS 66061-7243 |
Second Address | Olathe, KS 66061-7243 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2006 |
Last Update Date | 05/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
033D00169 | WPS (01) | KS |
200383900C | (05) | KS |
I47746 | (02) | FL |