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NPI Code Detail

MEDICARE: PEARISH J SMITH MD

MEDICARE: PEARISH J SMITH MD
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
1207P00000XEmergency Medicine PhysicianA66372CA
2207Q00000XFamily Medicine PhysicianA66372CA
3207Q00000XFamily Medicine Physician34591AZ

Other Identifiers

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

General Provider Information

NPI Number : 1619998200
Entity Type Code : Individual
Provider Name (Legal Business Name) : PEARISH J SMITH MD
Provider Business Mailing Address
First Line : 500 INDIANA AVE
Second Line :
City : WINSLOW
State : AZ
Zip : 86047-2169
Country : US
Telephone Number : 928-289-4646
Fax Number : 928-283-6231
Provider Business Practice Location Address
First Line : 500 INDIANA AVE
Second Line :
City : WINSLOW
State : AZ
Zip : 86047-2169
Country : US
Telephone Number : 928-289-4646
Fax Number : 928-283-6231
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2006
Last Update Date : 04/20/2026

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