Provider Demographics
NPI:1134313802
Name:SMITH, VALERIE ANN (DO)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:ANN
Last Name:SMITH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1111
Mailing Address - Country:US
Mailing Address - Phone:334-440-3061
Mailing Address - Fax:334-557-1057
Practice Address - Street 1:2024 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1111
Practice Address - Country:US
Practice Address - Phone:334-440-3061
Practice Address - Fax:334-557-1057
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2024-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR4780208D00000X
FLOS19184208D00000X
ARE11235208D00000X
WAOP60075821208D00000X
CA20A18151208D00000X
390200000X
ALDO.3825208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARPENDINGMedicaid
TXPENDINGMedicaid