Provider Demographics
NPI:1811475452
Name:CHRISTOPHER C SMITH MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:CHRISTOPHER C SMITH MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:DENMARK
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-470-0510
Mailing Address - Street 1:1200 W MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:AL
Mailing Address - Zip Code:36340-1642
Mailing Address - Country:US
Mailing Address - Phone:334-684-3655
Mailing Address - Fax:
Practice Address - Street 1:1200 W MAPLE AVE
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:AL
Practice Address - Zip Code:36340-1642
Practice Address - Country:US
Practice Address - Phone:334-684-3655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty