Healthcare Provider Details

I. General information

NPI: 1295122331
Provider Name (Legal Business Name): CHRISTOPHER RASHAD SMITH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2015
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 HARDEE AVE SW BLDG 125
ATLANTA GA
30310-5110
US

IV. Provider business mailing address

1701 HARDEE AVE SW BLDG 125
ATLANTA GA
30310-5110
US

V. Phone/Fax

Practice location:
  • Phone: 404-230-5683
  • Fax:
Mailing address:
  • Phone: 404-230-5683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number80236
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number80236
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: