Ezra E Smith, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY-005110 Issued in AZ

Practice address

2450 E River Rd
Tucson, AZ 85718-6526

Phone

(520) 795-7750

NPI assigned

May 17, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559260800000",
    "number": "1124684865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 E RIVER RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857186526",
            "telephone_number": "631-319-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 E RIVER RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857186526",
            "telephone_number": "520-795-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EZRA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-17",
        "last_updated": "2019-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "PSY-005110",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "PSY-005110",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AZ",
            "license": "PSY-005110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emiko J Smith, M.S. CCC-SLP
• Emily Smith, PAC
• Eric Smith
• Eric Lynn Smith, PHARM.D.
• Eric Reuben Smith, MD, MPH
• Finn Smith
• Garrett Smith, N.M.D.
• Glenda J Smith, M.S., NCSP
• Gregg T Smith, FNP-C
• Gregory James Duane Smith

• Clinical Neuropsychologist in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Clinical Neuropsychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.