Individual
JEVIN ALLEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
525 WESTERN AVE, SUITE 201, CONWAY, AR 72034-4967
(501) 327-6665
(501) 730-0289
Mailing address
525 WESTERN AVE, SUITE 201, CONWAY, AR 72034-4967
(501) 327-6665
(501) 730-0289
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
E-5962
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5H894
BCBS
—
01
—
E-5962
STATE MEDICAL LICENSE
AR
Enumeration date
04/25/2007
Last updated
12/04/2009
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