Provider Demographics
NPI:1265967772
Name:SMITH, KIM BINKLEY (PD)
Entity type:Individual
Prefix:DR
First Name:KIM
Middle Name:BINKLEY
Last Name:SMITH
Suffix:
Gender:F
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 S DONAGHEY AVE
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-8659
Mailing Address - Country:US
Mailing Address - Phone:501-733-0228
Mailing Address - Fax:
Practice Address - Street 1:1850 S DONAGHEY AVE
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-8659
Practice Address - Country:US
Practice Address - Phone:501-733-0228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-23
Last Update Date:2017-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD07386183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist