Basic Information
| Provider Information | |||||||||
| NPI: | 1174835136 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SMITH | ||||||||
| FirstName: | BLAIR | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2340 E MEYER BLVD STE 546 | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641321110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8169260777 | ||||||||
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| Practice Location | |||||||||
| Address1: | 395 W 12TH AVE | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432101267 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142934532 | ||||||||
| FaxNumber: | 6142935877 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2010 | ||||||||
| LastUpdateDate: | 01/04/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VX0201X | 04-39969 | KS | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecologic Oncology | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207VX0201X | 2017014169 | MO | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecologic Oncology |
No ID Information.