Provider Demographics
NPI:1134113046
Name:SMOKER, STEVE E (PD)
Entity Type:Individual
Prefix:MR
First Name:STEVE
Middle Name:E
Last Name:SMOKER
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 1:1001 W KINGSHIGHWAY
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-4142
Mailing Address - Country:US
Mailing Address - Phone:870-239-4036
Mailing Address - Fax:870-239-9478
Practice Address - Street 1:1001 W KINGSHIGHWAY
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-4142
Practice Address - Country:US
Practice Address - Phone:870-239-4036
Practice Address - Fax:870-239-9478
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR6827183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1125210001Medicare ID - Type Unspecified