Healthcare Provider Details

I. General information

NPI: 1194989426
Provider Name (Legal Business Name): JAMES D SMITH MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2008
Last Update Date: 07/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5354 REYNALDS ST SUITE 225
SAVANNAH GA
31405
US

IV. Provider business mailing address

5354 REYNALDS ST SUITE 225
SAVANNAH GA
31405
US

V. Phone/Fax

Practice location:
  • Phone: 912-355-5593
  • Fax: 912-355-5404
Mailing address:
  • Phone: 912-355-5593
  • Fax: 912-355-5404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number016431
License Number StateGA

VIII. Authorized Official

Name: JAMES D SMITH
Title or Position: PRESIDENT
Credential: MD
Phone: 912-355-5593