Provider Demographics
NPI:1144212523
Name:SMITH, HARRY SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:SCOTT
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 CLUB LANE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-3681
Mailing Address - Country:US
Mailing Address - Phone:501-329-1510
Mailing Address - Fax:501-329-5697
Practice Address - Street 1:550 CLUB LANE
Practice Address - Street 2:SUITE 1
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-3681
Practice Address - Country:US
Practice Address - Phone:501-329-1510
Practice Address - Fax:501-329-5697
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE3734207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR03070011700OtherQUAL CHOICE
AR5M604OtherBCBS
AR150308001Medicaid
ARP00090866OtherRR MEDICARE
ARH91476Medicare UPIN
AR150308001Medicaid