Provider Demographics
NPI:1063444628
Name:SMITH, ROYSHANDA CZELL (MD)
Entity type:Individual
Prefix:DR
First Name:ROYSHANDA
Middle Name:CZELL
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 E LOVE JOY LOOP
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36610-3923
Mailing Address - Country:US
Mailing Address - Phone:504-957-3448
Mailing Address - Fax:504-957-3448
Practice Address - Street 1:107 E LOVE JOY LOOP STE 650
Practice Address - Street 2:
Practice Address - City:PRICHARD
Practice Address - State:AL
Practice Address - Zip Code:36610-3923
Practice Address - Country:US
Practice Address - Phone:251-753-4328
Practice Address - Fax:251-753-4328
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL29098207V00000X, 207V00000X
GA69962207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL315885Medicaid
MS02527821Medicaid
LA1052159Medicaid