Provider Demographics
NPI:1801854062
Name:SMITH, NORMA (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NORMA
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 11708
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72917-1708
Mailing Address - Country:US
Mailing Address - Phone:479-484-7100
Mailing Address - Fax:479-478-7225
Practice Address - Street 1:8101 MCCLURE DR STE 101
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72916-6040
Practice Address - Country:US
Practice Address - Phone:479-484-7100
Practice Address - Fax:479-478-7255
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE1935202K00000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No202K00000XAllopathic & Osteopathic PhysiciansPhlebology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5L009OtherBCBS
AR5L009OtherBCBS
ARE72598Medicare UPIN