| NPI | 1174699664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILBERT D SMITH Owner 573-686-2811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO R5B27) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 118754) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2020-08-22 |