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Dr. Rodney Smith
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NPI Number Detailed Information
Provider Information:
| Name: | Dr. Rodney Smith |
| Gender: | M |
| Provider License Number If Given: | 6457 |
NPI Information:
| NPI: | 1720087380 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 7/18/2005 |
| Last Update Date: | 7/8/2007 |
Provider Business Mailing Address:
| Address: | 1206 S MAIN ST Maryville, MO 64468 |
| Phone Number: | 6605825959 |
| Fax Number: | 6605826373 |
Provider Business Practice Location Address:
| Address: | 1206 S MAIN ST Maryville, MO 64468 |
| Phone Number: | 6605825959 |
| Fax Number: | 6605826373 |
Provider Taxonomy:
| Primary: | 111N00000X |
| Secondary (if any): | |
| State: | MO |
