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General NPI Number Information
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NPI Number | 1891483731
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Entity Type | Individual
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Provider Name | GARY SMITHSON DO
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Gender | Male
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Dates
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Enumeration Date | 04/27/2023
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 1301 S CRISMON RD
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City | MESA
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State | AZ
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Zip | 85209-3767
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Country | US
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Telephone | 480-358-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 2090 E LINDA LN
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City | GILBERT
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State | AZ
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Zip | 85234-6210
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Country | US
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Telephone | 480-737-8510
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 011342
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License Number State | AZ
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