Provider Demographics
NPI:1962497461
Name:SMITH, ARTHUR APPLEBY (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:APPLEBY
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 1:800 E HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-2844
Mailing Address - Country:US
Mailing Address - Phone:618-632-3518
Mailing Address - Fax:618-632-9330
Practice Address - Street 1:800 E HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:IL
Practice Address - Zip Code:62269-2844
Practice Address - Country:US
Practice Address - Phone:618-632-3518
Practice Address - Fax:618-632-9330
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E21645Medicare UPIN
208378Medicare ID - Type Unspecified