Healthcare Provider Details

I. General information

NPI: 1851346563
Provider Name (Legal Business Name): STEVEN R SMITH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 WHITESPORT DR SW
HUNTSVILLE AL
35801-6449
US

IV. Provider business mailing address

201 WHITESPORT DR SW
HUNTSVILLE AL
35801-6449
US

V. Phone/Fax

Practice location:
  • Phone: 256-881-5353
  • Fax: 256-881-7012
Mailing address:
  • Phone: 256-881-5353
  • Fax: 256-881-7012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number9716
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: