Provider Demographics
NPI:1083746002
Name:SMART, JAMES EARL (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:EARL
Last Name:SMART
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19317 NORWICH RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1226
Mailing Address - Country:US
Mailing Address - Phone:248-756-0137
Mailing Address - Fax:248-960-1861
Practice Address - Street 1:47300 PONTIAC TRL
Practice Address - Street 2:
Practice Address - City:WIXOM
Practice Address - State:MI
Practice Address - Zip Code:48393-2551
Practice Address - Country:US
Practice Address - Phone:248-960-0352
Practice Address - Fax:248-960-1861
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302022070183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist