Healthcare Provider Details

I. General information

NPI: 1669933792
Provider Name (Legal Business Name): WILLIAM BRADEN SMITH D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2019
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PILOT MEDICAL DR STE 100
BIRMINGHAM AL
35235-3412
US

IV. Provider business mailing address

PO BOX 55309
BIRMINGHAM AL
35255-5309
US

V. Phone/Fax

Practice location:
  • Phone: 205-854-8084
  • Fax: 205-815-9341
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberDO.2910
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberDO.2910
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: