# SAMUEL SMITH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1124118799
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0120X | Pediatric Surgery Physician | C-5848 | AR | Yes |

## Other

- **Enumeration date:** 10/13/2006
- **Last updated:** 03/06/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 020033263 | RAILROAD MEDICARE | AR |
| 01 | — | 12039000000 | QUALCHOICE | AR |
| 05 | — | 121199001 | — | AR |
| 01 | — | 55251 | BLUE CROSS BLUE SHIELD | AR |
| 01 | — | C5848 | TRICARE | AR |