Smith, Tracy Todd

Smith, Tracy Todd is an individual health care provider with primary practice located at 3120 Clearwater Dr , Prescott AZ 86305-7131. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Smith, Tracy Todd can be contacted via phone (928) 771-3704.

Contact Information

Primary practice address
3120 Clearwater Dr Prescott AZ 86305-7131
Fax: (928) 771-0434
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 64049 Arizona

Profile Details

NPI number 1821067448
LBN Legal business name Smith, Tracy Todd
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2006
Last updated May 8th, 2024 - about 6 months 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 1821067448 NPPES
Arizona MEDICAID 099496

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