Smith, Kevin L

Smith, Kevin L is an individual health care provider with primary practice located at 1990 Connecticut Ave S , Sartell MN 56377-2554. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Smith, Kevin L can be contacted via phone (320) 257-5595.

Contact Information

Primary practice address
1990 Connecticut Ave S Sartell MN 56377-2554
Phone: (320) 257-5595
Fax: (320) 257-5596
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 42088 Minnesota

Profile Details

NPI number 1194725424
LBN Legal business name Smith, Kevin L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2005
Last updated Aug 11th, 2011 - about 13 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 1194725424 NPPES
Minnesota Other 16-02418 MEDICA
Minnesota Other HP38324 MEDICA
Minnesota Other 128440C561 MEDICA
Minnesota Other 300138882 MEDICA
Minnesota Other 883131 MEDICA
Minnesota Other 411772562 MEDICA
Minnesota Other 411772562 MEDICA
Minnesota Other 67G97SM MEDICA
Minnesota MEDICAID 627622900 MEDICA
Minnesota Other 965251022160 MEDICA

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