Provider Demographics
NPI:1013136118
Name:A HORTON SMITH MD, PC
Entity Type:Organization
Organization Name:A HORTON SMITH MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:C
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-265-2555
Mailing Address - Street 1:420 LOWELL DR SE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3754
Mailing Address - Country:US
Mailing Address - Phone:256-265-2555
Mailing Address - Fax:256-265-2424
Practice Address - Street 1:420 LOWELL DR SE
Practice Address - Street 2:SUITE 400
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3754
Practice Address - Country:US
Practice Address - Phone:256-265-2555
Practice Address - Fax:256-265-2424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3416207VH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VH0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC75011Medicare UPIN
AL000005863Medicare ID - Type Unspecified