Individual provider · Type 1 NPI
Marissa Smith
Medical Physician Assistant · Phoenix, AZ
NPI number
1215752589
Active
Practice location
2601 E Roosevelt St
Phoenix, AZ 85008-4973
Mailing address
2929 E Thomas Rd
Phoenix, AZ 85016-8034
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 10967 (AZ) |
Medical Physician Assistant: Definition to come...
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About NPI 1215752589
Marissa Smith's National Provider Identifier is 1215752589, issued on Nov 20, 2024. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Phoenix, AZ. The record was last updated on Feb 13, 2025.