Individual
DR. CODY ROSS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1673 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1919
(479) 521-0200
(479) 521-4942
Mailing address
PO BOX 1523, FAYETTEVILLE, AR 72702-1523
(479) 571-6038
(479) 582-0222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-8488
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5I440
BC/BS
AR
Enumeration date
06/26/2012
Last updated
08/14/2024
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