Individual provider · NPI-1

Dr. Leroy Carter Smith, M.D.

Surgery · Bullhead City, AZ

NPI number1700830601

StatusActive

Last updated in NPPESFeb 21, 2012

Details

NPI: 1700830601
Entity type: Individual (NPI-1)
Name: Dr. Leroy Carter Smith
Credential: M.D.
Sex: Male
Sole proprietor: No
Enumeration date: May 22, 2006
Last updated: Feb 21, 2012

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
208600000X	Surgery	41584	AZ	Yes
207QA0505X	Family Medicine, Adult Medicine	26371	NC
207QG0300X	Family Medicine, Geriatric Medicine	26371	NC

Practice location

2755 Silver Creek Rd
Suite 111
Bullhead City, AZ 86442-7904

Phone 928-704-7163 · Fax 928-704-7140

Mailing address

2755 Silver Creek Rd
Suite 111
Bullhead City, AZ 86442-7904

Phone 928-704-7163 · Fax 928-704-7140

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