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NPI Code Detail

MEDICARE: STEVEN S. SMITH DO

MEDICARE: STEVEN S. SMITH DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianR7220MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2149354OTHERMOBLUE CROSS

General Provider Information

NPI Number : 1164420196
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN S. SMITH DO
Provider Business Mailing Address
First Line : 1500 N WESTWOOD BLVD
Second Line :
City : POPLAR BLUFF
State : MO
Zip : 63901-3318
Country : US
Telephone Number : 573-339-0909
Fax Number :
Provider Business Practice Location Address
First Line : 1500 N WESTWOOD BLVD
Second Line :
City : POPLAR BLUFF
State : MO
Zip : 63901-3318
Country : US
Telephone Number : 573-339-0909
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2005
Last Update Date : 12/11/2013

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Directions to “ STEVEN S. SMITH DO” Practice Location

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