Healthcare Provider Details

I. General information

NPI: 1013896869
Provider Name (Legal Business Name): SMITH JEFFRIES OGDEN PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5540 HIGHWAY 431 S STE A
BROWNSBORO AL
35741-9771
US

IV. Provider business mailing address

5540 HIGHWAY 431 S STE A
BROWNSBORO AL
35741-9771
US

V. Phone/Fax

Practice location:
  • Phone: 256-883-9494
  • Fax: 256-883-9490
Mailing address:
  • Phone: 256-883-9494
  • Fax: 256-883-9490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH12411
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: