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General NPI Number Information
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NPI Number | 1295716348
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Entity Type | Individual
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Provider Name | SHANNON HILLMAN SMALLEY DO
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Gender | Female
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 08/11/2014
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Provider Practice Location Address
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Address Line | 1300 N 12TH ST SUITE 301
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City | PHOENIX
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State | AZ
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Zip | 85006-2848
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Country | US
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Telephone | 602-839-6968
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Fax | 602-839-4144
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Provider Business Mailing Address
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Address Line | 1300 N 12TH ST SUITE 301
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City | PHOENIX
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State | AZ
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Zip | 85006-2848
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Country | US
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Telephone | 602-839-6968
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Fax | 602-839-4144
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 4227
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License Number State | AZ
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