Smith, Gordon V
Smith, Gordon V is an sole proprietor health care provider with primary practice located at 2055 Normandie Dr 108, Montgomery AL 36111-2732. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Smith, Gordon V can be contacted via phone (334) 288-4624.Contact Information
Primary practice address
2055 Normandie Dr 108
Montgomery AL 36111-2732
Phone: (334) 288-4624
Fax: (334) 280-3628
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 00024974 | Alabama |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 044877 | Georgia |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | ME90199 | Florida |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | MD24974 | Alabama |
Profile Details
| NPI number | 1154393841 |
|---|---|
| LBN Legal business name | Smith, Gordon V |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 6th, 2006 |
| Last updated | Oct 20th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154393841 | NPPES |
| Alabama | MEDICAID | 106707 | |
| Alabama | MEDICAID | 108067 | |
| Alabama | MEDICAID | 107000 | |
| Alabama | MEDICAID | 108566 | |
| Alabama | MEDICAID | 009922425 |
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