Provider Demographics
NPI:1407968464
Name:SMITH, KIT D (MD)
Entity Type:Individual
Prefix:
First Name:KIT
Middle Name:D
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3340 NORTH CENTER ST
Mailing Address - Street 2:#800
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-7406
Mailing Address - Country:US
Mailing Address - Phone:801-990-1910
Mailing Address - Fax:801-990-1912
Practice Address - Street 1:359 - 8TH AVENUE
Practice Address - Street 2:ASC
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84103
Practice Address - Country:US
Practice Address - Phone:801-408-3200
Practice Address - Fax:801-733-5618
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT76-160179-1205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID804070300Medicaid
UT8597445OtherWORKERS COMP FUND
UT37820OtherPEHP
UTQM0000075886OtherALTIUS
UT1502954OtherUMWA
UT35764OtherDESERET MUTUAL
UT10238OtherHEALTHY U
WY110456000Medicaid
AZ822412Medicaid
UTPRA02722OtherMOLINA
NV002086529Medicaid
UT870545614SM1OtherEDUCATORS MUTUAL
UT107005299101OtherIHC
UT2090168OtherUNITED HEALTHCARE
UT35764OtherDESERET MUTUAL
UTQM0000075886OtherALTIUS
UT10238OtherHEALTHY U