Provider Demographics
NPI:1407071780
Name:SMITH, SCOTT A (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:A
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
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Mailing Address - Street 1:7047 E GREENWAY PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-8107
Mailing Address - Country:US
Mailing Address - Phone:480-998-1685
Mailing Address - Fax:480-998-1754
Practice Address - Street 1:7047 E GREENWAY PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-8107
Practice Address - Country:US
Practice Address - Phone:480-998-1685
Practice Address - Fax:480-998-1754
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2014-11-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ7017111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ4402118OtherUNITED HEALTH CARE
AZAW5995OtherHEALTHNET
AZ420938710OtherBLUE CROSS BLUE SHIELD
AZ420938710OtherBLUE CROSS BLUE SHIELD