Individual
STEPHANIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
US HIGHWAY 191 AND HOSPITAL DRIVE, CHINLE, AZ 86503
(928) 674-7001
Mailing address
PO BOX PH, CHINLE, AZ 86503-8000
(314) 362-5000
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
2016019162
MO
207V00000X
Obstetrics & Gynecology Physician
Primary
2020015135
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2020015135
STATE MEDICAL LICENSE
MO
Enumeration date
07/18/2016
Last updated
08/17/2020
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