Provider Demographics
NPI:1346613700
Name:ROYSHANDA C SMITH MD LLC
Entity type:Organization
Organization Name:ROYSHANDA C SMITH MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROYSHANDA
Authorized Official - Middle Name:CZELL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-957-3448
Mailing Address - Street 1:107 E LOVE JOY LOOP
Mailing Address - Street 2:
Mailing Address - City:PRICHARD
Mailing Address - State:AL
Mailing Address - Zip Code:36610-3923
Mailing Address - Country:US
Mailing Address - Phone:504-957-3448
Mailing Address - Fax:
Practice Address - Street 1:107 E LOVE JOY LOOP
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:504-957-3448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-07
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL29098302F00000X
207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1052159Medicaid