Smith, Cody Ross
Smith, Cody Ross is an individual health care provider with primary practice located at 1673 N College Ave , Fayetteville AR 72703-1919. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Smith, Cody Ross can be contacted via phone (479) 521-0200.Contact Information
Primary practice address
1673 N College Ave
Fayetteville AR 72703-1919
Phone: (479) 521-0200
Fax: (479) 521-4942
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | E-8488 | Arkansas |
Profile Details
| NPI number | 1588928436 |
|---|---|
| LBN Legal business name | Smith, Cody Ross |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 26th, 2012 |
| Last updated | Dec 29th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588928436 | NPPES |
| Arkansas | Other | 5I440 | BC/BS |
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