Provider Demographics
NPI:1407854151
Name:SMITH, MELANIE H (MD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:H
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 RICHARDS RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2650
Mailing Address - Country:US
Mailing Address - Phone:501-975-7550
Mailing Address - Fax:501-975-7553
Practice Address - Street 1:4020 RICHARDS RD
Practice Address - Street 2:SUITE B
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2650
Practice Address - Country:US
Practice Address - Phone:501-975-7550
Practice Address - Fax:501-975-7553
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-2450174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR443474OtherHEALTHLINK
AR139132001Medicaid
AR5017498OtherAETNA
AR18706000000OtherQUAL CHOICE
AR1969712OtherUNITED HEALTHCARE
AR139132001Medicaid
ARP00061161Medicare PIN
AR5L384Medicare PIN