Provider Demographics
NPI:1649274358
Name:SMITH, TARSHA L (DC)
Entity type:Individual
Prefix:DR
First Name:TARSHA
Middle Name:L
Last Name:SMITH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1166 PHILLIPS 357
Mailing Address - Street 2:
Mailing Address - City:POPLAR GROVE
Mailing Address - State:AR
Mailing Address - Zip Code:72374-9308
Mailing Address - Country:US
Mailing Address - Phone:870-816-6776
Mailing Address - Fax:870-572-9003
Practice Address - Street 1:307 PLAZA
Practice Address - Street 2:
Practice Address - City:WEST HELENA
Practice Address - State:AR
Practice Address - Zip Code:72390-2453
Practice Address - Country:US
Practice Address - Phone:870-572-9003
Practice Address - Fax:870-572-9003
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1614111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR157357718Medicaid
AR5Y294Medicare ID - Type Unspecified
AR157357718Medicaid