Healthcare Provider Details

I. General information

NPI: 1346613700
Provider Name (Legal Business Name): ROYSHANDA C SMITH MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2015
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 E LOVE JOY LOOP
PRICHARD AL
36610-3923
US

IV. Provider business mailing address

107 E LOVE JOY LOOP
PRICHARD AL
36610-3923
US

V. Phone/Fax

Practice location:
  • Phone: 504-957-3448
  • Fax:
Mailing address:
  • Phone: 504-957-3448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number29098
License Number StateAL

VIII. Authorized Official

Name: DR. ROYSHANDA CZELL SMITH
Title or Position: OWNER
Credential: MD
Phone: 504-957-3448