Provider Demographics
NPI:1982677845
Name:SMITH, ELIZABETH CARTER (MS,PT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CARTER
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS,PT
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 830633
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35283-0633
Mailing Address - Country:US
Mailing Address - Phone:205-838-3900
Mailing Address - Fax:205-838-3906
Practice Address - Street 1:52 MEDICAL PARK DR E
Practice Address - Street 2:SUITE 115
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3430
Practice Address - Country:US
Practice Address - Phone:205-838-3900
Practice Address - Fax:205-838-3906
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3714225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51503288OtherBLUE CROSS BLUE SHIELD
P20811Medicare UPIN