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General NPI Number Information
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NPI Number | 1134327240
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Entity Type | Organization
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Legal Business Name | R JAY SMITH MD PC
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 02/14/2008
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Provider Practice Location Address
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Address Line | 801 PRINCETON AVE SW PROF BUILDING 1 STE 330
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City | BIRMINGHAM
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State | AL
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Zip | 35211
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Country | US
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Telephone | 205-788-7136
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Fax | 205-788-7928
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Provider Business Mailing Address
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Address Line | 801 PRINCETON AVE SW PROF BUILDING 1 STE 330
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City | BIRMINGHAM
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State | AL
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Zip | 35211
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Country | US
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Telephone | 205-788-7136
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Fax | 205-788-7928
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Authorized Official
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Title or Position | OWNER SURGEON
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Name | MR. RONALD JAY SMITH
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Credential | MD
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Telephone | 205-788-7136
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD12142
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 12142
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License Number State | AL
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