Provider Demographics
NPI:1477621852
Name:SMITH, ALFORD A (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFORD
Middle Name:A
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:PO BOX 4189
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-4189
Mailing Address - Country:US
Mailing Address - Phone:954-363-9582
Mailing Address - Fax:954-363-9663
Practice Address - Street 1:1950 W HILLSBORO BLVD STE 103
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-1423
Practice Address - Country:US
Practice Address - Phone:954-408-8960
Practice Address - Fax:954-408-8961
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY156297207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00832339Medicaid
NYAS021D4610OtherBCBS
NYKP198OtherOXFORD
NY00832339Medicaid
NY21D461Medicare ID - Type UnspecifiedMEDICARE