Jason Kindle, PT
Individual provider Active NPI Specialist · Smithton, MO
NPI 1992844450 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1992844450
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 105632 (MO)
- Practice address
- 505 S Myrtle Ave
Smithton, MO 65350-1038 - Phone
- (660) 343-5316
- Fax
- (660) 343-5389
- NPI assigned
- Feb 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105632 | MO | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| School District R 6 Smithton | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 105632 | MO | Yes |
Addresses
Primary practice location
505 S Myrtle Ave
Smithton, MO 65350-1038
Mailing address
505 S Myrtle Ave
Smithton, MO 65350-1038
Phone (660) 343-5316
Other providers in Smithton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.