Provider Demographics
NPI:1003803529
Name:SMETS, WILLIAM M (PD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:M
Last Name:SMETS
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 S 26TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72901-4118
Mailing Address - Country:US
Mailing Address - Phone:479-782-5940
Mailing Address - Fax:
Practice Address - Street 1:3610 GRAND AVE
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72904-6842
Practice Address - Country:US
Practice Address - Phone:479-783-5171
Practice Address - Fax:479-783-0433
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR6836183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist