MEDICARE: MERLYN DEAN SMITH DO

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
1	207Q00000X	Family Medicine Physician	2010	AZ
2	208600000X	Surgery Physician	2010	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275544322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERLYN DEAN SMITH DO

Provider Business Mailing Address
First Line	:	606 N COUNTRY CLUB DR
Second Line	:	#1 CLINIC OF PHYSICIANS AND SURGEONS
City	:	MESA
State	:	AZ
Zip	:	85201-5700
Country	:	US
Telephone Number	:	480-733-4400
Fax Number	:	480-969-0976

Provider Business Practice Location Address
First Line	:	606 N COUNTRY CLUB DR
Second Line	:	#1 CLINIC OF PHYSICIANS AND SURGEONS
City	:	MESA
State	:	AZ
Zip	:	85201-5700
Country	:	US
Telephone Number	:	480-733-4400
Fax Number	:	480-969-0976

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	09/11/2025

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Directions to “ MERLYN DEAN SMITH DO” Practice Location

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