Smith, Charles Melvin

Smith, Charles Melvin is an individual health care provider with primary practice located at 2000 W Bethany Home Rd , Phoenix AZ 85015-2443. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Smith, Charles Melvin can be contacted via phone (602) 249-0212.

Contact Information

Primary practice address
2000 W Bethany Home Rd Phoenix AZ 85015-2443
Phone: (602) 249-0212
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 15726 Arizona

Profile Details

NPI number 1144211855
LBN Legal business name Smith, Charles Melvin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated Jul 8th, 2007 - about 18 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 1144211855 NPPES
Arizona Other 3981220 EYECARE
Arizona Other AW1436 EYECARE
Arizona Other AZ0728670 EYECARE
Arizona MEDICAID 260266 EYECARE

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