Individual
RONALD D SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
527 N 6TH ST, BLYTHEVILLE, AR 72315-2407
(870) 763-4541
Mailing address
527 N 6TH ST, BLYTHEVILLE, AR 72315-2407
(870) 763-4541
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C-4413
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103451001
—
AR
01
—
54986
BLUECROSS BLUESHIELD
AR
01
—
P00346420
RAILROAD MEDICARE
AR
Enumeration date
06/05/2006
Last updated
06/17/2008
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