Smith, Jill Marie
Smith, Jill Marie is an sole proprietor health care provider with primary practice located at 4181 Broadway St , Kansas City MO 64111-2620. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Smith, Jill Marie can be contacted via phone (816) 756-3577.Contact Information
Primary practice address
4181 Broadway St
Kansas City MO 64111-2620
Phone: (816) 756-3577
Fax: (816) 756-3069
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | T03249 | Missouri |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1468 | Kansas |
Profile Details
| NPI number | 1760454730 |
|---|---|
| LBN Legal business name | Smith, Jill Marie |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 3rd, 2006 |
| Last updated | Mar 31st, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760454730 | NPPES |
| Kansas | MEDICAID | 100220990D | |
| Kansas | MEDICAID | 318585205 |
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