Provider Demographics
NPI:1952694036
Name:SMITH, ELIZABETH ELLEN (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ELLEN
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7301 E 2ND ST
Mailing Address - Street 2:STE 210
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-5600
Mailing Address - Country:US
Mailing Address - Phone:480-882-4545
Mailing Address - Fax:480-946-6997
Practice Address - Street 1:1124 E MCKELLIPS RD STE 110
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-2766
Practice Address - Country:US
Practice Address - Phone:480-882-7370
Practice Address - Fax:480-649-2832
Is Sole Proprietor?:No
Enumeration Date:2011-05-23
Last Update Date:2023-09-25
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Provider Licenses
StateLicense IDTaxonomies
AZ49744207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine