Provider Demographics
NPI:1407418866
Name:SMITH, ARUTHUR J
Entity Type:Individual
Prefix:
First Name:ARUTHUR
Middle Name:J
Last Name:SMITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 POPLAR AVE STE 6E
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38112-3854
Mailing Address - Country:US
Mailing Address - Phone:901-552-3597
Mailing Address - Fax:901-590-4068
Practice Address - Street 1:2600 POPLAR AVE STE 6E
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-3854
Practice Address - Country:US
Practice Address - Phone:901-552-3597
Practice Address - Fax:901-590-4068
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-05
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)