Smith, Stacy R.

Smith, Stacy R. is an individual health care provider with primary practice located at 561 Saxony Pl Suite 102, Encinitas CA 92024-7700. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Smith, Stacy R. can be contacted via phone (760) 203-3839.

Contact Information

Primary practice address
561 Saxony Pl Suite 102 Encinitas CA 92024-7700
Phone: (760) 203-3839
Fax: (760) 203-3840
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X G65407 California

Profile Details

NPI number 1780651760
LBN Legal business name Smith, Stacy R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2006
Last updated Oct 29th, 2013 - about 13 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 1780651760 NPPES
California Other G65407 MEDICAL LICENSE

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