Individual
JORDAN LEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
707 N ALVERNON WAY, TUCSON, AZ 85711-1827
(520) 694-8000
Mailing address
PO BOX 245064, TUCSON, AZ 85724-5064
(520) 626-6607
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
34414
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
446540
—
AZ
05
—
87303221
—
NM
01
—
Z132751
MEDICARE ID
AZ
Enumeration date
12/11/2006
Last updated
02/01/2012
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