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General NPI Number Information
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NPI Number | 1932111895
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Entity Type | Individual
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Provider Name | LINDA ANN SMITH M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 06/18/2019
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Provider Practice Location Address
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Address Line | 101 HOSPITAL LOOP NE SUITE 106
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-2129
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Country | US
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Telephone | 505-828-0404
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Fax |
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Provider Business Mailing Address
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Address Line | 8020 CONSTITUTION PL NE STE 202
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-7640
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Country | US
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Telephone | 505-559-5628
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Fax | 505-998-3100
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 83-302
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License Number State | NM
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