Healthcare Provider Details

I. General information

NPI: 1407760366
Provider Name (Legal Business Name): KADEN SMITH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3460 US HIGHWAY 431 STE C
ALBERTVILLE AL
35950-0203
US

IV. Provider business mailing address

PO BOX 1162
JACKSONVILLE AL
36265-5162
US

V. Phone/Fax

Practice location:
  • Phone: 256-239-5662
  • Fax: 256-217-4162
Mailing address:
  • Phone: 256-239-5662
  • Fax: 256-217-4162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberALC05277
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: