Individual
GREGG ALAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1042 N HIGLEY RD, SUITE 102-602, MESA, AZ 85205-5398
(480) 242-6297
(480) 699-3129
Mailing address
3928 E MINTON CIR, MESA, AZ 85215-1727
(480) 242-6297
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2813
AZ
208M00000X
Hospitalist Physician
2813
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619184652
NPI
—
01
—
318198
AHCCCS
AZ
Enumeration date
10/05/2005
Last updated
10/31/2018
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