Healthcare Provider Details

I. General information

NPI: 1487844627
Provider Name (Legal Business Name): LINDA ANN SMITH MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HOSPITAL LOOP NE STE 106
ALBUQUERQUE NM
87109-2100
US

IV. Provider business mailing address

101 HOSPITAL LOOP NE STE 106
ALBUQUERQUE NM
87109-2100
US

V. Phone/Fax

Practice location:
  • Phone: 505-828-0404
  • Fax: 505-797-2850
Mailing address:
  • Phone: 505-828-0404
  • Fax: 505-797-2850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. HAROLD GLENN FIELD
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 505-828-0404