MEDICARE: DAVID M SMOCK MD

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
1	207R00000X	Internal Medicine Physician	P0139	TX
2	207R00000X	Internal Medicine Physician	57645	AZ
3	208M00000X	Hospitalist Physician	2013002540	MO
4	207R00000X	Internal Medicine Physician	04-36109	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2013002540	OTHER	MO	MO LICENSE

General Provider Information

NPI Number	:	1780850214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID M SMOCK MD

Provider Business Mailing Address
First Line	:	PO BOX 746874
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6874
Country	:	US
Telephone Number	:	312-733-9730
Fax Number	:	312-929-0373

Provider Business Practice Location Address
First Line	:	700 NEBRASKA AVE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66101-2111
Country	:	US
Telephone Number	:	913-951-8731
Fax Number	:	913-426-9057

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2008
Last Update Date	:	03/28/2025

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Directions to “ DAVID M SMOCK MD” Practice Location

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