Healthcare Provider Details

I. General information

NPI: 1801356894
Provider Name (Legal Business Name): JOSIAH DAVID SMILEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 12/05/2022
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 TUSCALOOSA AVE SW
BIRMINGHAM AL
35211-1948
US

IV. Provider business mailing address

405 BELCHER ST
CENTREVILLE AL
35042-2946
US

V. Phone/Fax

Practice location:
  • Phone: 205-679-6325
  • Fax: 205-783-8600
Mailing address:
  • Phone: 205-926-2992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.45245
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: