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
Phone: (928) 771-3704
Fax: (928) 771-0434
Website:
Health care specialties
| Specialty | Code | License # | 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 last year |
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 | 1821067448 | NPPES |
| Arizona | MEDICAID | 099496 |
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