Individual
THURMAN GREGORY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3317 N WIMBERLY DR, FAYETTEVILLE, AR 72703-4056
(479) 521-2752
(479) 521-4603
Mailing address
PO BOX 1608, FAYETTEVILLE, AR 72702-1608
(479) 587-3149
(479) 521-4603
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
PA-539
AR
363AM0700X
Medical Physician Assistant
Primary
PA-539
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71-0412695
TAX ID
AR
Enumeration date
07/30/2013
Last updated
03/05/2024
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