Individual
TIMOTHY D SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
15215 S 48TH ST, SUITE 113, PHOENIX, AZ 85044-9142
(480) 961-9299
(480) 961-1802
Mailing address
7975 N HAYDEN RD, STE D354, SCOTTSDALE, AZ 85258-3243
(480) 214-9720
(480) 214-9722
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
4778
AZ
363AM0700X
Medical Physician Assistant
PA9104364
FL
363AS0400X
Surgical Physician Assistant
Primary
4778
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264533500
—
FL
Enumeration date
11/08/2007
Last updated
10/19/2023
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