| Kenny E. Smith M.d.,pc | |
|
760 Chestnut St Gadsden AL 35901-4147 | |
| (256) 543-1100 | |
| (256) 543-1101 |
| Full Name | Kenny E. Smith M.d.,pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 760 Chestnut St, Gadsden, Alabama |
| Authorized Official Name and Position | Kenny E Smith (PHYSICIAN/OWNER) |
| Authorized Official Contact | 2565431100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenny E. Smith M.d.,pc 760 Chestnut St Gadsden AL 35901-4147 Ph: (256) 543-1100 | Kenny E. Smith M.d.,pc 760 Chestnut St Gadsden AL 35901-4147 Ph: (256) 543-1100 |
| NPI Number | 1629176151 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6406849116 |
|---|---|
| Medicare Enrollment ID | O20040407001105 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629176151 | NPI | - | NPPES |
| 51080192 | Other | AL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Alabama) | Primary |
| Provider Name | Kenny E Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295736460 PECOS PAC ID: 2062405673 Enrollment ID: I20040410000092 |
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