Smith, Charles
Smith, Charles is an individual health care provider with primary practice located at 2920 N 4Th St , Flagstaff AZ 86004-1816. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Smith, Charles can be contacted via phone (928) 213-6100.Contact Information
Primary practice address
2920 N 4Th St
Flagstaff AZ 86004-1816
Phone: (928) 213-6100
Fax: (928) 774-4808
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 28946 | Arizona |
Profile Details
| NPI number | 1053383950 |
|---|---|
| LBN Legal business name | Smith, Charles |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 3rd, 2006 |
| Last updated | Nov 14th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053383950 | NPPES |
| Arizona | MEDICAID | 719536 |
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