Individual
DR. BIANCA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
44765 WEST HATHAWAY ROAD, MARICOPA, AZ 85139-0545
(520) 788-6100
(520) 788-6140
Mailing address
PO BOX 10097, CASA GRANDE, AZ 85130-0020
(520) 836-3446
(520) 836-8807
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
006625
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023675
—
AZ
01
—
03-1814
MEDICARE
—
01
—
031815
MEDICARE
—
01
—
031916
MEDICARE
—
01
—
Z178880
MEDICARE
—
01
—
ZFQ31814
MEDICARE
—
Enumeration date
04/21/2011
Last updated
07/21/2022
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