Provider Demographics
NPI:1821264912
Name:SMITH, LAWRENCE (R, RT, MR)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:SMITH
Suffix:
Gender:M
Credentials:R, RT, MR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2019 E RACE AVE
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4725
Mailing Address - Country:US
Mailing Address - Phone:501-368-0657
Mailing Address - Fax:501-368-0658
Practice Address - Street 1:2019 E RACE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4725
Practice Address - Country:US
Practice Address - Phone:501-368-0657
Practice Address - Fax:501-368-0658
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3146422471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance Imaging