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NPI Code Detail

MEDICARE: DR. ROGER H SMITH D.O.

MEDICARE: DR. ROGER H SMITH D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianDO343AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
151511321OTHERALBLUECROSS PROVIDER #

General Provider Information

NPI Number : 1467454421
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROGER H SMITH D.O.
Provider Business Mailing Address
First Line : 300 N COLLEGE ST
Second Line :
City : GREENVILLE
State : AL
Zip : 36037-2025
Country : US
Telephone Number : 334-382-2681
Fax Number : 334-383-9541
Provider Business Practice Location Address
First Line : 300 N COLLEGE ST
Second Line :
City : GREENVILLE
State : AL
Zip : 36037-2025
Country : US
Telephone Number : 334-382-2681
Fax Number : 334-383-9541
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2005
Last Update Date : 07/08/2007

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