| D A Smithyman, Llc | |
|
1601 Rainbow Rd Rogers AR 72758-8821 | |
| (479) 254-1144 | |
| (479) 254-1099 |
| Full Name | D A Smithyman, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1601 Rainbow Rd, Rogers, Arkansas |
| Authorized Official Name and Position | Deborah Anne Smithyman (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 4792006383 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| D A Smithyman, Llc 1601 Rainbow Rd Rogers AR 72758-8821 Ph: (479) 254-1144 | D A Smithyman, Llc 1601 Rainbow Rd Rogers AR 72758-8821 Ph: (479) 254-1144 |
| NPI Number | 1801191887 |
|---|---|
| Provider Enumeration Date | 01/21/2011 |
| Last Update Date | 09/19/2011 |
| Medicare PECOS PAC ID | 1254699853 |
|---|---|
| Medicare Enrollment ID | O20180102001548 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801191887 | NPI | - | NPPES |
| 1952307548 | Other | AR | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 10-09P (Arkansas) | Primary |
| Provider Name | Deborah A Smithyman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952307548 PECOS PAC ID: 1658459268 Enrollment ID: I20180102002158 |
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