Provider Demographics
NPI:1891026852
Name:K B SMITH, D.C., LLC
Entity Type:Organization
Organization Name:K B SMITH, D.C., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:NINA
Authorized Official - Last Name:NAMASTE
Authorized Official - Suffix:
Authorized Official - Credentials:CA
Authorized Official - Phone:913-648-8111
Mailing Address - Street 1:9209 W 110TH ST BLDG 36
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1401
Mailing Address - Country:US
Mailing Address - Phone:913-648-8111
Mailing Address - Fax:913-912-5870
Practice Address - Street 1:9209 W 110TH ST BLDG 36
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1401
Practice Address - Country:US
Practice Address - Phone:913-648-8111
Practice Address - Fax:913-912-5870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-14
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKS-01-04499111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
10895941OtherCAQH