Healthcare Provider Details

I. General information

NPI: 1366483653
Provider Name (Legal Business Name): ARTHUR A SMITH II RNFA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2113 E WILDHORSE DR
CHANDLER AZ
85286-1268
US

IV. Provider business mailing address

2113 E WILDHORSE DR
CHANDLER AZ
85286-1268
US

V. Phone/Fax

Practice location:
  • Phone: 480-748-7286
  • Fax:
Mailing address:
  • Phone: 480-748-7286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN107166
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN107166
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: