Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 15062 | AZ |
Y | 208600000X | Surgeon | 15062 | AZ |
NPI | 1003844291 |
---|---|
Provider Name | Dr. Patrick A Smith |
First Address | Tucson, AZ 85712-8000 |
Second Address | Tucson, AZ 85712-8000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
298332-02 | AHCCCS (01) | AZ |
2Z2580 | HEALTH NET (01) | AZ |
5819 | PACIFICARE (01) | AZ |
AZ0153500 | BCBS (01) | AZ |
B68090 | (02) | AZ |