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Individual

DR. BRYAN SCOTT SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
(602) 263-1619
Mailing address
PO BOX 95460, CLEVELAND, OH 44101-0033
(602) 581-6076
(602) 263-1619

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
27607
OK
2085R0202X
Diagnostic Radiology Physician
MD437673
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200282660A
OK
01
P00880580
RR MEDICARE
Enumeration date
07/09/2009
Last updated
11/10/2025
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