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General NPI Number Information
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NPI Number | 1992977102
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Entity Type | Organization
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Legal Business Name | J D SMITH DPM P C
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 05/08/2024
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Provider Practice Location Address
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Address Line | 202 ROSA LN
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City | FLORENCE
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State | AL
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Zip | 35630-1769
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Country | US
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Telephone | 256-764-1806
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Fax | 256-760-8442
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Provider Business Mailing Address
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Address Line | 202 ROSA LN
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City | FLORENCE
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State | AL
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Zip | 35630-1769
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Country | US
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Telephone | 256-764-1806
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Fax | 256-760-8442
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN DAVID SMITH
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Credential | DPM
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Telephone | 256-764-1806
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | #212
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | #212
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License Number State | AL
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