Provider Demographics
NPI:1053377226
Name:SMITH, JAMES (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11001 EXECUTIVE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4393
Mailing Address - Country:US
Mailing Address - Phone:501-851-7402
Mailing Address - Fax:501-851-4753
Practice Address - Street 1:1701 CLUB MANOR DR STE 2B
Practice Address - Street 2:
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-7401
Practice Address - Country:US
Practice Address - Phone:501-851-7402
Practice Address - Fax:501-851-4753
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2025-07-24
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Provider Licenses
StateLicense IDTaxonomies
ARE2410207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR470147001Medicaid
ARH13707Medicare UPIN
AR470147001Medicaid