Individual
MR. CHARLES L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
909 UNITY RD, CROSSETT, AR 71635-9444
(870) 364-9111
(870) 364-5581
Mailing address
PO BOX 340, CROSSETT, AR 71635-0340
(870) 364-9111
(870) 364-5581
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A01151 ANP
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132133758
—
AR
Enumeration date
01/25/2006
Last updated
02/08/2010
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