Healthcare Provider Details

I. General information

NPI: 1821495672
Provider Name (Legal Business Name): KAYLA SMITH AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2014
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 MEADOW LAKE DR STE 108
BIRMINGHAM AL
35242-0302
US

IV. Provider business mailing address

3000 MEADOW LAKE DR STE 108
BIRMINGHAM AL
35242-0302
US

V. Phone/Fax

Practice location:
  • Phone: 205-739-2242
  • Fax:
Mailing address:
  • Phone: 57-392-2422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number148
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1168A
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: