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General NPI Number Information
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NPI Number | 1679179543
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Entity Type | Organization
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Legal Business Name | LAYLA RENEE LUNDQUIST-SMITH MD, LLC
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Dates
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Enumeration Date | 12/07/2020
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Last Update Date | 12/07/2020
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Provider Practice Location Address
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Address Line | 609 E LAUREL ST
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City | ATMORE
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State | AL
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Zip | 36502
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Country | US
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Telephone | 251-362-6960
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Fax |
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Provider Business Mailing Address
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Address Line | 609 E LAUREL ST
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City | ATMORE
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State | AL
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Zip | 36502
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Country | US
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Telephone | 251-362-6960
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Fax |
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Authorized Official
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Title or Position | SOLE OWNER
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Name | LAYLA LUNDQUIST-SMITH
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Credential | MD
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Telephone | 850-529-4960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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