Smith, Kinim I

Smith, Kinim I is an sole proprietor health care provider with primary practice located at 3817 Mcmasters Ave Suite 150, Hannibal MO 63401-2488. She recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Rheumatology, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Rheumatology is her primary health care specialty. Smith, Kinim I can be contacted via phone (573) 221-0304.

Contact Information

Primary practice address
3817 Mcmasters Ave Suite 150 Hannibal MO 63401-2488
Phone: (573) 221-0304
Fax: (573) 221-0308
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 119287 Missouri
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X 119287 Missouri
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 119287 Missouri

Profile Details

NPI number 1275646473
LBN Legal business name Smith, Kinim I
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 15th, 2006
Last updated Dec 1st, 2015 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275646473 NPPES
Missouri MEDICAID 204666317
Missouri Other 000095293
Missouri Other MA1381

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