Individual
COURTNEY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2135 MALCOLM AVE, NEWPORT, AR 72112-3631
(870) 523-8003
(870) 523-8081
Mailing address
703 CALVIN AVERY DR, WEST MEMPHIS, AR 72301-6501
(870) 732-1878
(870) 702-7111
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220961795
—
AR
Enumeration date
08/24/2017
Last updated
08/24/2017
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