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:
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Health care specialties

SpecialtyCodeLicense #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 14 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 1760454730 NPPES
Kansas MEDICAID 100220990D
Kansas MEDICAID 318585205

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