Provider Demographics
NPI:1144721762
Name:DR. CHAD SMITH, LLC
Entity type:Organization
Organization Name:DR. CHAD SMITH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:SPENCER
Authorized Official - Middle Name:CHAD
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:870-305-5873
Mailing Address - Street 1:406 E SAINT LOUIS ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:AR
Mailing Address - Zip Code:71646-2728
Mailing Address - Country:US
Mailing Address - Phone:870-831-5016
Mailing Address - Fax:
Practice Address - Street 1:406 E SAINT LOUIS ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:AR
Practice Address - Zip Code:71646-2728
Practice Address - Country:US
Practice Address - Phone:870-831-5016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty