Provider Demographics
NPI:1225473762
Name:SMITH, DREW CURTIS
Entity Type:Individual
Prefix:
First Name:DREW
Middle Name:CURTIS
Last Name:SMITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 COUNTY ROAD 129
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOPE
Mailing Address - State:AL
Mailing Address - Zip Code:35651-9301
Mailing Address - Country:US
Mailing Address - Phone:256-221-8769
Mailing Address - Fax:
Practice Address - Street 1:1070 COUNTY ROAD 129
Practice Address - Street 2:
Practice Address - City:MOUNT HOPE
Practice Address - State:AL
Practice Address - Zip Code:35651-9301
Practice Address - Country:US
Practice Address - Phone:256-221-8769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10644390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program