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General NPI Number Information
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NPI Number | 1477733269
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Entity Type | Organization
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Legal Business Name | WILBURN A. SMITH, JR., M.D.
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Dates
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Enumeration Date | 11/08/2007
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Last Update Date | 12/01/2011
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Provider Practice Location Address
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Address Line | 4131 CARMICHAEL RD SUITE 28
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City | MONTGOMERY
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State | AL
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Zip | 36106-2801
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Country | US
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Telephone | 334-281-6363
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Fax | 334-284-4253
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Provider Business Mailing Address
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Address Line | 4131 CARMICHAEL RD SUITE 28
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City | MONTGOMERY
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State | AL
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Zip | 36106-2801
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Country | US
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Telephone | 334-281-6363
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Fax | 334-284-4253
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Authorized Official
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Title or Position | MANAGER/NURSE PRACTITIONER
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Name | LAURA H SMITH
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Credential | CRNP
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Telephone | 334-281-6363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 9125
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License Number State | AL
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