Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 3416 | AL |
NPI | 1013963867 |
---|---|
Provider Name | Dr. Almoth Horton Smith |
First Address | Huntsville, AL 35801-3754 |
Second Address | Huntsville, AL 35801-3754 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 17/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
51534699 | BLUE CROSS BLUE SHIELD (01) | AL |
C75011 | (02) | AL |