Individual
TRAVIS J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 N CENTRAL AVE, PHOENIX, AZ 85004-4414
(602) 255-7520
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 302-7620
(208) 302-7615
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-7035
AZ
363A00000X
Physician Assistant
PA-954
ID
363A00000X
Physician Assistant
—
—
Other
Enumeration date
12/01/2011
Last updated
04/22/2024
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