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NPI Code Detail

MEDICARE: HAYDEN WYATT SMITH

MEDICARE: HAYDEN WYATT SMITH
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
1225100000XPhysical TherapistPT017829GA

General Provider Information

NPI Number : 1477436590
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAYDEN WYATT SMITH
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : HOOVER
State : AL
Zip : 35242-5424
Country : US
Telephone Number : 423-238-7217
Fax Number :
Provider Business Practice Location Address
First Line : 540 W CROSSVILLE RD STE 203
Second Line :
City : ROSWELL
State : GA
Zip : 30075-7524
Country : US
Telephone Number : 678-585-0175
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2025
Last Update Date : 12/01/2025

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Directions to “ HAYDEN WYATT SMITH ” Practice Location

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