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General NPI Number Information
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NPI Number | 1831206515
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Entity Type | Individual
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Provider Name | RICHARD C SMITH MD
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Gender | Male
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 05/04/2010
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Provider Practice Location Address
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Address Line | 2729 S HIGHWAY 65 82
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City | LAKE VILLAGE
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State | AR
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Zip | 71653-6136
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Country | US
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Telephone | 870-632-9091
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Fax | 662-537-4888
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Provider Business Mailing Address
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Address Line | 755 S WASHINGTON AVE
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City | GREENVILLE
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State | MS
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Zip | 38701-5832
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Country | US
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Telephone | 870-632-9091
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Fax | 662-537-4888
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 15057
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | E-6378
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License Number State | AR
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