Provider Demographics
NPI:1508830795
Name:SMITH, BRUCE L JR (MD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:L
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 MERCY LN
Mailing Address - Street 2:SUITE 404
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6442
Mailing Address - Country:US
Mailing Address - Phone:501-321-1026
Mailing Address - Fax:501-623-1021
Practice Address - Street 1:1 MERCY LN
Practice Address - Street 2:SUITE 404
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6442
Practice Address - Country:US
Practice Address - Phone:501-321-1026
Practice Address - Fax:501-623-1021
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2010-12-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARC4861207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR104926001Medicaid
AR54927OtherBLUE CROSS BLUE SHIELD
AR4152730001OtherCIGNA GOVERNMENT SERVICES
AR54927OtherBLUE CROSS BLUE SHIELD