Provider Demographics
NPI:1649597097
Name:DAVID SMITHSON MD LLC
Entity Type:Organization
Organization Name:DAVID SMITHSON MD LLC
Other - Org Name:BODYLOGICMD OF BIRMINGHAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITHSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:866-399-6811
Mailing Address - Street 1:150 S PERRY ST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36104-4227
Mailing Address - Country:US
Mailing Address - Phone:866-399-6811
Mailing Address - Fax:866-399-6812
Practice Address - Street 1:6801 CAHABA VALLEY RD
Practice Address - Street 2:SUITE 208
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-9608
Practice Address - Country:US
Practice Address - Phone:866-399-6811
Practice Address - Fax:866-399-6812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-26
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12632174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty