Provider Demographics
NPI:1740484112
Name:SMITH, JORDANA MARGARET (MD)
Entity type:Individual
Prefix:DR
First Name:JORDANA
Middle Name:MARGARET
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:655 N ALVERNON
Mailing Address - Street 2:SUITE 204
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711
Mailing Address - Country:US
Mailing Address - Phone:520-626-0059
Mailing Address - Fax:520-626-2042
Practice Address - Street 1:707 N ALVERNON
Practice Address - Street 2:SUITE 301
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711
Practice Address - Country:US
Practice Address - Phone:520-694-1460
Practice Address - Fax:520-694-1425
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2018-10-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMT191275208600000X
AZ46295207WX0110X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
No208600000XAllopathic & Osteopathic PhysiciansSurgery