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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