Provider Demographics
NPI:1629000856
Name:SMITH, ARTHUR L (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:L
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:PO BOX 8620
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29604-8620
Mailing Address - Country:US
Mailing Address - Phone:864-295-0051
Mailing Address - Fax:864-295-0058
Practice Address - Street 1:103 CLAIR DR
Practice Address - Street 2:SUITE D
Practice Address - City:PIEDMONT
Practice Address - State:SC
Practice Address - Zip Code:29673-6400
Practice Address - Country:US
Practice Address - Phone:864-295-0051
Practice Address - Fax:864-295-0058
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20771207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP3513Medicaid
SCP00014838OtherRAILROAD MEDICARE
SC7454Medicare ID - Type Unspecified
SCP00014838OtherRAILROAD MEDICARE