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NPI Code Detail

MEDICARE: RICHARD LEE SMITH M.D.

MEDICARE: RICHARD LEE SMITH M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician107238MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861448664
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD LEE SMITH M.D.
Provider Business Mailing Address
First Line : 1502 N JEFFERSON ST
Second Line : ATTN: JEAN STEELE
City : CARROLLTON
State : MO
Zip : 64633-1948
Country : US
Telephone Number : 660-542-1695
Fax Number : 660-542-0363
Provider Business Practice Location Address
First Line : 1502 N JEFFERSON ST
Second Line :
City : CARROLLTON
State : MO
Zip : 64633-1948
Country : US
Telephone Number : 660-542-9998
Fax Number : 660-542-9880
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 12/05/2024

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