MEDICARE: ROBERT W. SMITH M.D, P.C.

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
1	261Q00000X	Clinic/Center	10568	AL

General Provider Information

NPI Number	:	1609144229
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT W. SMITH M.D, P.C.

Provider Business Mailing Address
First Line	:	1700 5TH AVE N
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35203-2023
Country	:	US
Telephone Number	:	205-251-0401
Fax Number	:	205-251-0250

Provider Business Practice Location Address
First Line	:	1700 5TH AVE N
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35203-2023
Country	:	US
Telephone Number	:	205-251-0401
Fax Number	:	205-251-0250

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT WILLIAM SMITH
Credential	:	M.D.
Telephone Number	:	205-251-0401

Provider Enumeration Date	:	12/09/2011
Last Update Date	:	12/09/2011

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