Healthcare Provider Details

I. General information

NPI: 1144417049
Provider Name (Legal Business Name): DAVID G. SMITHSON, MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 09/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 CARONDELET DR SUITE 329
KANSAS CITY MO
64114-4859
US

IV. Provider business mailing address

1000 CARONDELET DR MAIL STOP #9
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 Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License NumberR8N64
License Number StateMO

VIII. Authorized Official

Name: MR. DAVID GERARD SMITHSON
Title or Position: MEDICAL DIRECTOR INPT. REHAB UNIT
Credential: M.D.
Phone: 816-943-4554