Individual
MR. ROBERT LARRY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
260D SHOPPINGWAY BLVD, WEST MEMPHIS, AR 72301-7230
(901) 303-5040
Mailing address
5504 NORTH ST, BARTLETT, TN 38134-3458
(901) 382-0347
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
A005873
AR
363LF0000X
Family Nurse Practitioner
Primary
A005873
AR
363LF0000X
Family Nurse Practitioner
APN0000014593
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
TN
Enumeration date
01/27/2010
Last updated
05/04/2021
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