Individual
DR. JOHN C SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 S 7TH ST, OZARK, AR 72949-3131
(479) 452-2077
Mailing address
PO BOX 3528, FORT SMITH, AR 72913-3528
(479) 452-2077
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
C-4863
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020019149
RR MEDICARE
—
05
—
102243001
—
AR
Enumeration date
08/05/2006
Last updated
09/19/2007
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