Provider Demographics
NPI:1578595203
Name:SMITH, ADAM B (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:B
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 1:1130 22ND ST S SUITE 1000
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-2881
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25734 AL-195
Practice Address - Street 2:
Practice Address - City:DOUBLE SPRINGS
Practice Address - State:AL
Practice Address - Zip Code:35553-2213
Practice Address - Country:US
Practice Address - Phone:205-221-9494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL38551207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00124448Medicaid
AL073104561OtherBCBS OF AL
AL073104561OtherBCBS OF AL
H11621Medicare UPIN