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General NPI Number Information
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NPI Number | 1811988942
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Entity Type | Individual
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Provider Name | STEPHEN G SMITH MD
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Gender | Male
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Dates
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Enumeration Date | 10/28/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 17300 N OUTER 40 SUITE 100
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City | CHESTERFIELD
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State | MO
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Zip | 63005-1361
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Country | US
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Telephone | 636-519-8889
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Fax | 636-536-0120
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Provider Business Mailing Address
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Address Line | 17300 NORTH OUTER 40 ROAD SUITE 100
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City | HESTERFIELD
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State | MO
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Zip | 00000
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Country | US
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Telephone | 636-728-1977
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Fax | 636-778-1488
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | R3N29
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License Number State | MO
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