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NPI Code Detail

MEDICARE: ZACHARY YORK SMITH

MEDICARE: ZACHARY YORK SMITH
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
1175T00000XPeer SpecialistAK

General Provider Information

NPI Number : 1679424022
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZACHARY YORK SMITH
Provider Business Mailing Address
First Line : 591 S KNIK GOOSE BAY RD
Second Line :
City : WASILLA
State : AK
Zip : 99654-8062
Country : US
Telephone Number : 907-313-1333
Fax Number : 907-313-1333
Provider Business Practice Location Address
First Line : 126 WASHINGTON ST
Second Line :
City : KETCHIKAN
State : AK
Zip : 99901-5954
Country : US
Telephone Number : 907-313-1333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/03/2026

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Directions to “ ZACHARY YORK SMITH ” Practice Location

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