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1831206515

NPI Code Detail

MEDICARE: RICHARD C SMITH MD

MEDICARE: RICHARD C 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	2085R0202X	Diagnostic Radiology Physician	15057	MS
2	2085R0202X	Diagnostic Radiology Physician	E-6378	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00316066	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831206515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD C SMITH MD

Provider Business Mailing Address
First Line	:	755 S WASHINGTON AVE
Second Line	:
City	:	GREENVILLE
State	:	MS
Zip	:	38701-5832
Country	:	US
Telephone Number	:	870-632-9091
Fax Number	:	662-537-4888

Provider Business Practice Location Address
First Line	:	2729 S HIGHWAY 65 82
Second Line	:
City	:	LAKE VILLAGE
State	:	AR
Zip	:	71653-6136
Country	:	US
Telephone Number	:	870-632-9091
Fax Number	:	662-537-4888

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

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	05/04/2010

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Directions to “ RICHARD C SMITH MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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