# BOARD CERTIFIED FAMILY PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336358407
- **Authorized official:** MRS. LISA LYNN SMITH (OFFICE MANAGER)
- **Authorized official phone:** (870) 763-7695

## Contact information

- **Practice address:** 527 NORTH SIXTH STREET, BLYTHEVILLE, AR 72315-2790
- **Practice address phone:** (870) 763-4541
- **Practice address fax:** (870) 762-2390
- **Mailing address:** 527 NORHT SIXTH ST, BLYTHEVILLE, AR 72315-2790
- **Mailing address phone:** (870) 763-4541
- **Mailing address fax:** (870) 762-2390

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | AR | Yes |

## Other

- **Enumeration date:** 05/22/2007
- **Last updated:** 03/03/2014