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NPI Code Detail

MEDICARE: MIKAL ANN SMOKER PA-C

MEDICARE: MIKAL ANN SMOKER PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA2004-0021NM

General Provider Information

NPI Number : 1164425260
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIKAL ANN SMOKER PA-C
Provider Business Mailing Address
First Line : 6100 PAN AMERICAN FRWY NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87109
Country : US
Telephone Number : 505-823-8282
Fax Number :
Provider Business Practice Location Address
First Line : 401 SAN MATEO BLVD SE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-2921
Country : US
Telephone Number : 505-462-7333
Fax Number : 505-462-7333
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 08/26/2020

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Directions to “ MIKAL ANN SMOKER PA-C” Practice Location

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