Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | E3735 | AR |
NPI | 1023092343 |
---|---|
Provider Name | Melanie F. Smith |
First Address | Conway, AR 72032-5424 |
Second Address | Conway, AR 72032-5424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2005 |
Last Update Date | 23/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
149833001 | (05) | AR |
H62499 | (02) | AR |