Provider Demographics
NPI:1740505445
Name:SMITH, MCCASEY R (MD)
Entity type:Individual
Prefix:DR
First Name:MCCASEY
Middle Name:R
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8500
Mailing Address - Country:US
Mailing Address - Phone:913-588-6776
Mailing Address - Fax:913-588-6765
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:KU DEPARTMENT OF REHABILITATION MEDICINE
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8500
Practice Address - Country:US
Practice Address - Phone:913-588-6776
Practice Address - Fax:913-588-6765
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-06
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KS04-37269208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program