Provider Demographics
NPI:1790928661
Name:SMITH, RICHARD JASON (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JASON
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 1:131 EMILY CIR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-3169
Mailing Address - Country:US
Mailing Address - Phone:501-317-6030
Mailing Address - Fax:
Practice Address - Street 1:1000 1ST ST N
Practice Address - Street 2:MAIL SLOT 584
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8703
Practice Address - Country:US
Practice Address - Phone:501-686-8586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-08
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.31542207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine