MEDICARE: DR. JENNIFER REED SMITH D.O.

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	207Q00000X	Family Medicine Physician	3139	AZ

General Provider Information

NPI Number	:	1063436590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER REED SMITH D.O.

Provider Business Mailing Address
First Line	:	5111 N SCOTTSDALE RD STE 100
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85250-7076
Country	:	US
Telephone Number	:	602-224-9218
Fax Number	:	602-224-0078

Provider Business Practice Location Address
First Line	:	5111 N SCOTTSDALE RD STE 108
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85250-7076
Country	:	US
Telephone Number	:	602-224-9218
Fax Number	:	602-224-0078

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	08/17/2020

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