Healthcare Provider Details

I. General information

NPI: 1629293675
Provider Name (Legal Business Name): R.D. BLIM & E.E. SMITH, M.D.'S INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 BROADWAY ST SUITE 200
KANSAS CITY MO
64111-3498
US

IV. Provider business mailing address

4400 BROADWAY ST SUITE 200
KANSAS CITY MO
64111-3498
US

V. Phone/Fax

Practice location:
  • Phone: 816-561-8100
  • Fax: 816-561-8154
Mailing address:
  • Phone: 816-561-8100
  • Fax: 816-561-8154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. CHRISTY LYNN CAIN
Title or Position: SUPERVISOR
Credential:
Phone: 816-746-8190