Healthcare Provider Details

I. General information

NPI: 1396305371
Provider Name (Legal Business Name): CONOR ALAN SMITH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2019
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 S NEW BALLAS RD STE 510
SAINT LOUIS MO
63141-8726
US

IV. Provider business mailing address

701 S NEW BALLAS RD STE 510
SAINT LOUIS MO
63141-8726
US

V. Phone/Fax

Practice location:
  • Phone: 314-251-6710
  • Fax: 314-251-6712
Mailing address:
  • Phone: 314-251-6710
  • Fax: 314-251-6712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberU8823
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number2025029952
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: