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General NPI Number Information
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NPI Number | 1174529887
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Entity Type | Individual
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Provider Name | MARK ALAN SMITH MD
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Gender | Male
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Dates
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Enumeration Date | 06/27/2005
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 100 SHADOW OAKS DR
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City | SHERWOOD
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State | AR
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Zip | 72120-6046
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Country | US
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Telephone | 501-681-6181
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Fax | 501-983-4376
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Provider Business Mailing Address
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Address Line | 5308 RIDGE RD
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City | JACKSONVILLE
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State | AR
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Zip | 72076-8907
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Country | US
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Telephone | 501-681-6181
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Fax | 501-983-4376
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | E4293
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License Number State | AR
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