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General NPI Number Information
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NPI Number | 1295787174
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Entity Type | Individual
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Provider Name | RODNEY WILSON SMITH M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 05/27/2021
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Provider Practice Location Address
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Address Line | 631 COX RD
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City | GASTONIA
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State | NC
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Zip | 28054-3438
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Country | US
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Telephone | 704-864-7764
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Fax | 704-867-7894
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Provider Business Mailing Address
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Address Line | 9735 KINCEY AVE SUITE 201
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-9118
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Country | US
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Telephone | 704-414-2870
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Fax | 704-414-2860
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 25022
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License Number State | NC
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