Provider Demographics
NPI:1447694823
Name:SMITH, TERRY DANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:DANIEL
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:805 SAINT VINCENTS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1638
Mailing Address - Country:US
Mailing Address - Phone:205-939-3699
Mailing Address - Fax:205-581-7155
Practice Address - Street 1:805 SAINT VINCENTS DR STE 100
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205
Practice Address - Country:US
Practice Address - Phone:205-939-3699
Practice Address - Fax:205-581-7155
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.37077207Q00000X, 207QS0010X
GA077142207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program