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General NPI Number Information
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NPI Number | 1588617666
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Entity Type | Individual
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Provider Name | STEVEN MICHAEL SMITH CRNP
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Gender | Male
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 07/02/2014
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Provider Practice Location Address
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Address Line | 470 TAYLOR RD SUITE 310
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City | MONTGOMERY
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State | AL
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Zip | 36117-3563
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Country | US
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Telephone | 334-244-4322
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Fax | 334-244-4321
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Provider Business Mailing Address
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Address Line | 301 BROWN SPRINGS RD ATTN: PROVIDER ENROLLMENT
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City | MONTGOMERY
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State | AL
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Zip | 36117-7005
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Country | US
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Telephone | 334-273-4508
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Fax | 334-273-4290
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1-040648
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License Number State | AL
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