Healthcare Provider Details

I. General information

NPI: 1235135245
Provider Name (Legal Business Name): LINDA ANN SMOKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 UNIVERSITY BLVD NE
ALBUQUERQUE NM
87102-1727
US

IV. Provider business mailing address

800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-4400
  • Fax: 505-272-6308
Mailing address:
  • Phone: 505-272-1476
  • Fax: 505-272-6308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number97-374
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: