MEDICARE: SAM P SMITH DO LLC

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	207N00000X	Dermatology Physician	4237	AZ

General Provider Information

NPI Number	:	1710904636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAM P SMITH DO LLC

Provider Business Mailing Address
First Line	:	4915 E BASELINE RD
Second Line	:	SUITE 102
City	:	GILBERT
State	:	AZ
Zip	:	85234-2965
Country	:	US
Telephone Number	:	480-646-8660
Fax Number	:	480-646-8665

Provider Business Practice Location Address
First Line	:	4915 E BASELINE RD
Second Line	:	SUITE 102
City	:	GILBERT
State	:	AZ
Zip	:	85234-2965
Country	:	US
Telephone Number	:	480-646-8660
Fax Number	:	480-646-8665

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SAM P SMITH
Credential	:	D.O.
Telephone Number	:	602-369-6845

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	08/16/2013

Similar Medicare Providers

1649273814 — DR. PAYAM SARRAF D.P.M.
Practice Location Address:

4915 E BASELINE RD , SUITE 121
GILBERT, AZ
85234-2965

Practice Phone: 480-812-3668
Practice Fax: 480-782-1290

1770561656 — DEAN STEPHEN MOUSSER MD
Practice Location Address:

4915 E BASELINE RD , STE 119
GILBERT, AZ
85234-2965

Practice Phone: 480-832-0480
Practice Fax: 480-832-0490

1073587382 — DR. SAM REED SHIMAMOTO M.D.
Practice Location Address:

4915 E BASELINE RD , SUITE 112
GILBERT, AZ
85234-2965

Practice Phone: 480-626-6600
Practice Fax: 480-626-6604

1679603724 — FOOT ANKLE SPECIALTY CENTERS, LLC
Practice Location Address:

4915 E BASELINE ROAD , BLDG 8, SUITE 121
GILBERT, AZ
85234-2965

Practice Phone: 480-812-3668
Practice Fax:

1982825436 — MRS. AMY ZANGGER EBY CPNP
Practice Location Address:

4915 E BASELINE RD , STE 119
GILBERT, AZ
85234-2965

Practice Phone: 480-832-0480
Practice Fax: 480-832-0490

1043410723 — CRAIG L. MECHELKE, D.O., LTD.
Practice Location Address:

4915 E BASELINE RD , SUITE 126
GILBERT, AZ
85234-2965

Practice Phone: 480-969-3096
Practice Fax: 480-969-0963

Directions to “SAM P SMITH DO LLC ” 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.