Healthcare Provider Details

I. General information

NPI: 1376802074
Provider Name (Legal Business Name): TEMPLETON SMITH III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2012
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 BRANSON LANDING BLVD STE 201A
BRANSON MO
65616-2052
US

IV. Provider business mailing address

PO BOX 7411626
CHICAGO IL
60674-5626
US

V. Phone/Fax

Practice location:
  • Phone: 417-335-7128
  • Fax: 417-348-8007
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2018012546
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: