MEDICARE: STACY RUTH SMITH M.D.

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	207W00000X	Ophthalmology Physician	6024879-1205	UT

General Provider Information

NPI Number	:	1639348899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACY RUTH SMITH M.D.

Provider Business Mailing Address
First Line	:	PO BOX 27688
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84127-0688
Country	:	US
Telephone Number	:	801-534-1360
Fax Number	:	801-366-9883

Provider Business Practice Location Address
First Line	:	1548 E 4500 S STE 105
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-5209
Country	:	US
Telephone Number	:	801-424-3090
Fax Number	:	801-424-3091

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

Provider Enumeration Date	:	02/21/2008
Last Update Date	:	01/21/2022

Similar Medicare Providers

1619978970 — MR. DOUGLAS MARR WOSETH M.D.
Practice Location Address:

1548 EAST 4500 SOUTH, , SUITE 202
SALT LAKE, UT
84117-5209

Practice Phone: 801-266-8841
Practice Fax: 801-266-0449

1891700498 — K AND A HOLDINGS
Practice Location Address:

4658 HOLLADAY BLVD
SALT LAKE CITY, UT
84117-5209

Practice Phone: 801-277-2696
Practice Fax:

1184846131 — DR. ADAM M BOWMAN MD
Practice Location Address:

1548 E 4500 S STE 105
SALT LAKE CITY, UT
84117-5209

Practice Phone: 14-243-0908
Practice Fax: 801-424-3091

1710242235 — DR. BRETON ADAM OREL YATES M.D.
Practice Location Address:

1548 E 4500 S , STE 202
SALT LAKE CITY, UT
84117-5209

Practice Phone: 801-679-4600
Practice Fax:

1538577655 — SALT LAKE PEDIATRIC DENTISTRY
Practice Location Address:

1548 E 4500 S STE 102
SALT LAKE CITY, UT
84117-5209

Practice Phone: 801-463-1900
Practice Fax:

1750150876 — CONFLUENCE COUNSELING PLLC
Practice Location Address:

1548 E 4500 S STE 201
SALT LAKE CITY, UT
84117-5209

Practice Phone: 801-252-5146
Practice Fax:

Directions to “ STACY RUTH SMITH M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.