=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144347139
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORMAN J SMITH MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/23/2007
-----------------------------------------------------
Last Update Date | 10/22/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 310 HOSPITAL DR SUITE 210
-----------------------------------------------------
City | MACON
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31217-3895
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 478-986-7486
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 310 HOSPITAL DR SUITE 210
-----------------------------------------------------
City | MACON
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31217-3895
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 478-986-7486
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | NORMAN J SMITH
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 478-986-7486
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------