| Kenneth D Smith, MD | |
|
1101 W Liberty, Parkland Health Center Dept Of Radiology, Farmington, MO 63640 | |
| (573) 760-8075 | |
| (573) 760-8358 |
| Full Name | Kenneth D Smith |
|---|---|
| Gender | Male |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 1101 W Liberty, Farmington, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316958531 | NPI | - | NPPES |
| 235639 | Other | CMR | |
| 945K1 | Other | MO | BCBS MO |
| 14989V14989 | Other | GHP | |
| 235639 | Other | AMER MEDSE | |
| STL1600408 | Other | UHC | |
| 235639 | Other | HL | |
| 8707 | Other | HEALTHCARE | |
| 945K1 | Other | IL BLUE | |
| 945K1 | Other | MO BLUE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | R8F26 (Missouri) | Primary |
| Entity Name | Ste Genevieve County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184658387 PECOS PAC ID: 3274432802 Enrollment ID: O20040102000645 |
| Entity Name | Ste Genevieve County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073587655 PECOS PAC ID: 3274432802 Enrollment ID: O20040312000516 |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth D Smith, MD Po Box 629, Smith Imaging Inc, Farmington, MO 63640 Ph: (573) 760-8075 | Kenneth D Smith, MD 1101 W Liberty, Parkland Health Center Dept Of Radiology, Farmington, MO 63640 Ph: (573) 760-8075 |
Troy Constant Avendanio, Radiology Medicare: Accepting Medicare Assignments Practice Location: 1101 W Liberty St, Dept. Of Radiology, Farmington, MO 63640 Phone: 573-760-8075 | |
Kenneth L Miller, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1101 W Liberty, Parkland Health Center Dept Of Radiology, Farmington, MO 63640 Phone: 573-760-8075 Fax: 573-760-8358 |