Individual
MR. GLENNIS DALE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
5300 57TH ST N, BIRMINGHAM, AL 35217-3328
(205) 808-3220
Mailing address
20 SCOTTSDALE DR, ALABASTER, AL 35007-8994
(205) 685-9777
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA709
AL
Other
Enumeration date
06/01/2010
Last updated
06/01/2010
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