Provider Demographics
NPI:1306301940
Name:SMITH, KRISTEN LEIGH (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:LEIGH
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4076 NEELY ROAD
Mailing Address - Street 2:BLDG. 4076
Mailing Address - City:FT WAINWRIGHT
Mailing Address - State:AK
Mailing Address - Zip Code:99703-7440
Mailing Address - Country:US
Mailing Address - Phone:907-361-4000
Mailing Address - Fax:907-361-4809
Practice Address - Street 1:4076 NEELY ROAD
Practice Address - Street 2:BLDG. 4076
Practice Address - City:FT WAINWRIGHT
Practice Address - State:AK
Practice Address - Zip Code:99703-7440
Practice Address - Country:US
Practice Address - Phone:907-361-4000
Practice Address - Fax:907-361-4809
Is Sole Proprietor?:No
Enumeration Date:2019-02-07
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE33206208D00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice