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General NPI Number Information
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NPI Number | 1356429476
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Entity Type | Individual
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Provider Name | PHIL GARY SMITH PD
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Gender | Male
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 421 W MAIN ST
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City | TRUMANN
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State | AR
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Zip | 72472-3116
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Country | US
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Telephone | 870-483-6391
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Fax | 870-483-2710
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Provider Business Mailing Address
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Address Line | 31382 TULOT RD
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City | TRUMANN
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State | AR
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Zip | 72472-8469
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Country | US
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Telephone | 870-483-2205
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 05888
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License Number State | AR
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