Individual
MR. SHAWN CHRISTOPHER SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1432 S. DOBSON ROAD, SUITE 501, MESA, AZ 85202
(602) 404-3700
(602) 404-3703
Mailing address
1432 S. DOBSON ROAD, SUITE 501, MESA, AZ 85202
(602) 404-3700
(602) 404-3703
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
4577
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z138481
PTAN
AZ
Enumeration date
04/23/2010
Last updated
10/02/2012
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