Individual
DR. ELIZABETH ANNE SMITH-TRYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2082 MESQUITE AVE, STE 106, LAKE HAVASU CITY, AZ 86403-6710
(928) 680-4233
(928) 680-6522
Mailing address
1990 MCCULLOCH BLVD N, SUITE D-126, LAKE HAVASU CITY, AZ 86403-5749
(928) 680-4233
(928) 680-6522
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35026
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z150379
MEDICARE GROUP PTAN
AZ
01
—
Z150380
MEDICARE INDIVIDUAL PTAN
AZ
Enumeration date
01/03/2006
Last updated
02/09/2016
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