Organization
LAURIE SMITH FISHER, M.D., INC
Active
Organization
LAURIE SMITH FISHER, M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURIE SMITH FISHER M.D. (AUTHORIZED OFFICIAL)
(479) 968-7930
Entity
Organization
Contact information
Practice address
1100 E POPLAR ST, CLARKSVILLE, AR 72830-4419
(479) 754-5484
Mailing address
PO BOX 9178, RUSSELLVILLE, AR 72811-9178
(479) 968-7930
(479) 968-4331
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191779002
—
AR
01
—
5GA98
MEDICARE PTAN
—
Enumeration date
02/28/2012
Last updated
06/26/2012
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