Individual
DR. WESLEY LINCOLN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2500 E VAN BUREN ST, PHOENIX, AZ 85008-6037
(480) 695-6625
Mailing address
2500 E VAN BUREN ST, PHOENIX, AZ 85008-6037
(480) 695-6625
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2616
AZ
2084F0202X
Forensic Psychiatry Physician
2616
AZ
2084P0800X
Psychiatry Physician
Primary
2616
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
621822
—
AZ
01
—
AZ0724670
BCBS
—
Enumeration date
12/05/2006
Last updated
03/17/2018
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