Individual
MR. EDDIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1114 FERRY RD, OZARK, AR 72949-2591
(918) 649-5426
Mailing address
607 HOLSON AVE, POTEAU, OK 74953-4925
(918) 649-5426
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C00512
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881741635
NPI
OK
01
—
1881741635
NPI
—
Enumeration date
01/04/2007
Last updated
03/19/2010
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