Provider Demographics
NPI:1740991595
Name:SMITH, JARON (ABOC)
Entity type:Individual
Prefix:
First Name:JARON
Middle Name:
Last Name:SMITH
Suffix:
Gender:M
Credentials:ABOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5609 NW 86TH TER APT C28
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-2462
Mailing Address - Country:US
Mailing Address - Phone:816-808-2629
Mailing Address - Fax:
Practice Address - Street 1:4181 BROADWAY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2620
Practice Address - Country:US
Practice Address - Phone:816-808-2629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-12
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician