Provider Demographics
NPI:1922026145
Name:SMITH, ANN K (MD)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:K
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5701 W 119TH ST
Mailing Address - Street 2:SUITE 410
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-3721
Mailing Address - Country:US
Mailing Address - Phone:913-345-3650
Mailing Address - Fax:913-345-3797
Practice Address - Street 1:5701 W 119TH ST
Practice Address - Street 2:SUITE 410
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-3721
Practice Address - Country:US
Practice Address - Phone:913-345-3650
Practice Address - Fax:913-345-3797
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS24833207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1922026145Medicaid
KS100158990DMedicaid
KSP03000001Medicare PIN
KSP00746231Medicare PIN
KS100158990DMedicaid