Provider Demographics
NPI:1487757688
Name:SMITH, AUBREY LYNDOL III (MD)
Entity type:Individual
Prefix:MR
First Name:AUBREY
Middle Name:LYNDOL
Last Name:SMITH
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1600 S COULTER ST
Mailing Address - Street 2:BLDG B
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1710
Mailing Address - Country:US
Mailing Address - Phone:806-359-0718
Mailing Address - Fax:806-359-9613
Practice Address - Street 1:1600 S COULTER ST
Practice Address - Street 2:BLDG B
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1710
Practice Address - Country:US
Practice Address - Phone:806-359-0718
Practice Address - Fax:806-359-9613
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8421207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX089643301Medicaid
TXSM00F74GMedicare ID - Type Unspecified
TX089643301Medicaid