Healthcare Provider Details

I. General information

NPI: 1417947755
Provider Name (Legal Business Name): DAVID GERARD SMITHSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DAVID GERARD SMITHSON MD PC

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 CARONDELET DR
KANSAS CITY MO
64114-4859
US

IV. Provider business mailing address

1000 CARONDELET DR
KANSAS CITY MO
64114-4673
US

V. Phone/Fax

Practice location:
  • Phone: 816-943-4554
  • Fax: 816-943-4654
Mailing address:
  • Phone: 816-943-4554
  • Fax: 816-943-4654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberR8N64
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: