Smilack, Jerry D

Smilack, Jerry D is an individual health care provider with primary practice located at 5779 E Mayo Blvd , Phoenix AZ 85054-4502. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Smilack, Jerry D can be contacted via phone (480) 301-8000.

Contact Information

Primary practice address
5779 E Mayo Blvd Phoenix AZ 85054-4502
Phone: (480) 301-8000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 16720 Arizona

Profile Details

NPI number 1720061617
LBN Legal business name Smilack, Jerry D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 23rd, 2005
Last updated Oct 31st, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720061617 NPPES
Arizona MEDICAID 329690
Arizona Other 86080015085259A197

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