Individual
MR. JOHNNY LEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
502 WEST COURT, JASPER, AR 72641
(870) 446-2203
(870) 446-2206
Mailing address
PO BOX 445, JASPER, AR 72641-0445
(870) 446-2203
(870) 446-2206
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A01227
AR
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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