Provider Demographics
NPI:1770622441
Name:SMITH, JOEL NICHOLAS (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:NICHOLAS
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2504 MCCAIN BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-7669
Mailing Address - Country:US
Mailing Address - Phone:501-975-5633
Mailing Address - Fax:501-227-0710
Practice Address - Street 1:5320 W MARKHAM ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3528
Practice Address - Country:US
Practice Address - Phone:501-975-5633
Practice Address - Fax:501-227-0710
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-7428207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR192482001Medicaid
AR1730428483OtherNPI #
AR5AP64Medicare UPIN