Individual
DR. JASON A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4901 FAIRWAY AVE, SUITE C, NORTH LITTLE ROCK, AR 72116-6923
(501) 753-8444
(501) 753-9170
Mailing address
10201 KANIS RD, LITTLE ROCK, AR 72205-6203
(501) 227-5050
(501) 227-5151
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
E5080
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164668001
—
AR
01
—
E5080
STATE LICENSE
AR
01
—
P00419128
RAILROAD MEDICARE
AR
Enumeration date
02/13/2007
Last updated
05/27/2010
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