Healthcare Provider Details

I. General information

NPI: 1356454193
Provider Name (Legal Business Name): DAVID E SMITH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 INTERSTATE 630 # EXIT7
LITTLE ROCK AR
72205-7202
US

IV. Provider business mailing address

PO BOX 2119
LITTLE ROCK AR
72203-2119
US

V. Phone/Fax

Practice location:
  • Phone: 501-993-7923
  • Fax:
Mailing address:
  • Phone: 501-993-7923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberR2163
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberR2163
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: