Provider Demographics
NPI:1235158973
Name:SMITH, RICHARD FELIX (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:FELIX
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1936 OLD ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-2247
Mailing Address - Country:US
Mailing Address - Phone:205-978-3200
Mailing Address - Fax:205-978-5745
Practice Address - Street 1:1936 OLD ORCHARD RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-2247
Practice Address - Country:US
Practice Address - Phone:205-978-3200
Practice Address - Fax:205-978-5745
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5987208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1210246OtherUNITED HEALTHCARE PROVIDE
AL51030027OtherBLUE CROSS PROVIDER
ALF936OtherBLUE CROSS COMMON PAYER
AL63030730615OtherTRICARE PROVIDER NUMBER
AL0004006338OtherAETNA PIN NUMBER
AL90701OtherCIGNA PROVIDER NUMBER
AL90701OtherCIGNA PROVIDER NUMBER