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General NPI Number Information
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NPI Number | 1962519785
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Entity Type | Individual
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Provider Name | CRAIG R SMITH MD
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Gender | Male
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 09/27/2024
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Provider Practice Location Address
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Address Line | 330 1ST CAPITOL DR STE 100A
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City | SAINT CHARLES
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State | MO
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Zip | 63301-2846
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Country | US
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Telephone | 636-669-2332
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 60352
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City | SAINT LOUIS
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State | MO
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Zip | 63160-0352
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Country | US
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Telephone | 314-991-4644
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Fax | 866-342-0133
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 108607
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License Number State | MO
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