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General NPI Number Information
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NPI Number | 1447365168
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Entity Type | Organization
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Legal Business Name | PRODIGEE INPATIENT PHYSICIANS GROUP, P.L.L.C.
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 01/10/2008
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Provider Practice Location Address
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Address Line | 4711 E FALCON DR SUITE 355
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City | MESA
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State | AZ
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Zip | 85215-2593
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Country | US
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Telephone | 480-357-2048
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Fax | 480-214-5147
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Provider Business Mailing Address
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Address Line | 4711 E FALCON DR SUITE 355
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City | MESA
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State | AZ
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Zip | 85215-2593
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Country | US
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Telephone | 480-357-2048
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Fax | 480-214-5147
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. GREGG A SMITH
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Credential | D.O.
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Telephone | 480-357-2048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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