Provider Demographics
NPI:1952468068
Name:SMALLEY, DAVID BRYANT (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRYANT
Last Name:SMALLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2401 VILLAGE PROFESSIONAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-4702
Mailing Address - Country:US
Mailing Address - Phone:334-749-8121
Mailing Address - Fax:334-749-6166
Practice Address - Street 1:2401 VILLAGE PROFESSIONAL DRIVE
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-4702
Practice Address - Country:US
Practice Address - Phone:334-749-8121
Practice Address - Fax:334-749-6166
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12065208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL12065OtherALABAMA MEDICAL LICENSE
AL12065OtherALABAMA CONTR SUBST CERT
131985OtherAAP ID
AL515-17931OtherBCBS AL PROV # AUBURN
AL1210243OtherUNITED HEALTH PROV #
AL510-15109OtherBCBS AL PROV # OPELIKA
32263OtherAMERICAN BOARD PEDIATRICS
AS3211707OtherDEA
AL515-17931OtherBCBS AL PROV # AUBURN
AL12065OtherALABAMA CONTR SUBST CERT