Provider Demographics
NPI:1508998576
Name:SMITH, BENJAMIN H (MD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:H
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 N TUCSON BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-3423
Mailing Address - Country:US
Mailing Address - Phone:210-290-4314
Mailing Address - Fax:
Practice Address - Street 1:1502 N TUCSON BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-3423
Practice Address - Country:US
Practice Address - Phone:520-326-4321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2023-1594207W00000X
UT6207901-1205207W00000X
TXS4690207W00000X
AZ76662207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology