Individual
J D SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
202 ROSA LN, FLORENCE, AL 35630-1769
(256) 764-1806
(256) 760-8442
Mailing address
202 ROSA LN, FLORENCE, AL 35630-1769
(256) 764-1806
(256) 760-8442
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
212
AL
213ES0103X
Foot & Ankle Surgery Podiatrist
212
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1992977102
MEDICARE GROUP NUMBER
—
01
—
480002775
MEDICARE RAILROAD PTAN
—
01
—
51017836
BCBS PROVIDER
AL
Enumeration date
05/05/2006
Last updated
05/08/2024
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