MEDICARE: DR. JESSICA MARIE SMITH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	E-12239	AR

General Provider Information

NPI Number	:	1144682113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA MARIE SMITH MD

Provider Business Mailing Address
First Line	:	1661 AIRPORT RD STE D
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-8184
Country	:	US
Telephone Number	:	501-625-7500
Fax Number	:	501-625-7777

Provider Business Practice Location Address
First Line	:	1629 AIRPORT RD STE B
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-8069
Country	:	US
Telephone Number	:	501-767-0075
Fax Number	:	501-767-4455

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2016
Last Update Date	:	10/18/2023

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