Smith, Clarisa Idalia

Smith, Clarisa Idalia is an individual health care provider with primary practice located at 3001 Main St Suite 1C, Prescott Valley AZ 86314-2284. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Smith, Clarisa Idalia can be contacted via phone (928) 458-5470.

Contact Information

Primary practice address
3001 Main St Suite 1C Prescott Valley AZ 86314-2284
Phone: (928) 458-5470
Fax: (928) 458-5979
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 35537 Arizona

Profile Details

NPI number 1699845180
LBN Legal business name Smith, Clarisa Idalia
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2006
Last updated Jun 16th, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699845180 NPPES
Arizona MEDICAID 624951

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