MEDICARE: STACY R SMITH MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	60248791205	UT

General Provider Information

NPI Number	:	1003162058
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STACY R SMITH MD PC

Provider Business Mailing Address
First Line	:	1548 E 4500 S
Second Line	:	STE 105
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-4209
Country	:	US
Telephone Number	:	801-424-3090
Fax Number	:	801-424-3091

Provider Business Practice Location Address
First Line	:	1548 E 4500 S
Second Line	:	STE 105
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-4209
Country	:	US
Telephone Number	:	801-424-3090
Fax Number	:	801-424-3091

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	STACY R SMITH
Credential	:	M.D.
Telephone Number	:	801-424-3090

Provider Enumeration Date	:	07/27/2012
Last Update Date	:	05/13/2013

Similar Medicare Providers

1720149453 — JEFFERY K. RUPP D.M.D., M.S.
Practice Location Address:

1548 E 4500 S , SUITE 102
SALT LAKE CITY, UT
84117-4209

Practice Phone: 801-463-1900
Practice Fax:

1871783027 — DAVID GUSTAFSON DDS, MS
Practice Location Address:

1548 E 4500 S
SALT LAKE CITY, UT
84117-4209

Practice Phone: 801-463-1900
Practice Fax:

1831548098 — SHANE FARR P.A.
Practice Location Address:

1548 E 4500 S , STE 202
SALT LAKE CITY, UT
84117-4209

Practice Phone: 801-266-8841
Practice Fax:

1528424447 — NICOLE NOKLEBY DPT
Practice Location Address:

4209 S JUPITER DR
SALT LAKE CITY, UT
84124-3374

Practice Phone: 801-921-3725
Practice Fax:

1902445083 — YOUR HOME THERAPY LLC
Practice Location Address:

4209 S MONARCH WAY
SALT LAKE CITY, UT
84124-3125

Practice Phone: 310-367-7797
Practice Fax:

1861024440 — YOUR HOME THERAPY LLC
Practice Location Address:

4209 S MONARCH WAY
SALT LAKE CITY, UT
84124-3125

Practice Phone: 310-367-7797
Practice Fax:

Directions to “STACY R SMITH MD PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.