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Individual

JOHN P SMOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
11274 S FORTUNA RD STE I4, YUMA, AZ 85367-7849
(928) 345-2150
Mailing address
PO BOX 669, YUMA, AZ 85366-2329
(928) 247-6516

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4570
AZ

Other

Enumeration date
01/05/2010
Last updated
06/23/2023
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