Provider Demographics
NPI:1194138842
Name:SMITH, ANDREW T (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:T
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:70 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35125-9314
Mailing Address - Country:US
Mailing Address - Phone:205-814-9284
Mailing Address - Fax:205-814-9626
Practice Address - Street 1:7201 HAPPY HOLLOW ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173
Practice Address - Country:US
Practice Address - Phone:205-655-3721
Practice Address - Fax:205-655-3814
Is Sole Proprietor?:No
Enumeration Date:2014-06-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL35112207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine