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Individual

DR. SHANNON HILLMAN SMALLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1300 N 12TH ST, SUITE 301, PHOENIX, AZ 85006-2848
(602) 839-6968
(602) 839-4144
Mailing address
1300 N 12TH ST, SUITE 301, PHOENIX, AZ 85006-2848
(602) 839-6968
(602) 839-4144

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4227
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3981220
EVERCARE GRP #
AZ
01
453051001
GROUP HEALTH GRP #
05
457300
AZ
01
860373636
HUMANA GRP #
AZ
01
AW1436
HEALTHNET GRP #
AZ
01
AZ0728670
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
11/07/2005
Last updated
08/11/2014
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