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General NPI Number Information
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NPI Number | 1467768937
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Entity Type | Organization
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Legal Business Name | FAMILY DOCTORS OF ARIZONA, LLC
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Dates
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Enumeration Date | 08/23/2010
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 5656 S POWER RD
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City | GILBERT
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State | AZ
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Zip | 85295-8480
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Country | US
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Telephone | 480-373-2399
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Fax | 480-373-2396
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Provider Business Mailing Address
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Address Line | PO BOX 52992
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City | MESA
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State | AZ
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Zip | 85208-0150
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Country | US
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Telephone | 480-373-2399
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Fax | 480-373-2396
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Authorized Official
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Title or Position | OWNER
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Name | GARY A SMITH
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Credential | MD
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Telephone | 480-373-2399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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