Individual
DR. GINA LARAINE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9015 N 3RD ST, PHOENIX, AZ 85020-2444
(480) 882-4545
(602) 714-3755
Mailing address
7500 N DREAMY DRAW DR STE 145, PHOENIX, AZ 85020-4668
(480) 882-4545
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036105255
IL
207Q00000X
Family Medicine Physician
Primary
74097
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043326192
—
MI
05
—
174811
—
AZ
Enumeration date
08/22/2006
Last updated
11/15/2024
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