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NPI Code Detail

MEDICARE: CYNTHIA M SMITH PA-C

MEDICARE: CYNTHIA M SMITH PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant50-002328OH
2363AM0700XMedical Physician Assistant7814GA

General Provider Information

NPI Number : 1033179700
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA M SMITH PA-C
Provider Business Mailing Address
First Line : 3330 COBB PKWY NW STE 324-201
Second Line :
City : ACWORTH
State : GA
Zip : 30101-8320
Country : US
Telephone Number : 915-474-7675
Fax Number :
Provider Business Practice Location Address
First Line : 1275 HIGHWAY 54 W STE 201
Second Line :
City : FAYETTEVILLE
State : GA
Zip : 30214-4538
Country : US
Telephone Number : 770-461-3776
Fax Number : 770-461-3565
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2006
Last Update Date : 06/29/2022

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Directions to “ CYNTHIA M SMITH PA-C” Practice Location

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