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General NPI Number Information
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NPI Number | 1295818409
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Entity Type | Individual
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Provider Name | IGOR SMELYANSKY M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 1357 HEMBREE RD STE E220
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City | ROSWELL
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State | GA
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Zip | 30076-5722
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Country | US
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Telephone | 770-962-3642
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Fax | 770-962-3643
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Provider Business Mailing Address
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Address Line | 455 PHILIP BLVD STE 140
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-8768
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Country | US
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Telephone | 770-962-3642
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Fax | 770-962-3643
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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 | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 101776
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 101776
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 2084P2900X
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Taxonomy Name | Pain Medicine (Psychiatry & Neurology) Physician
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License Number | 47683
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License Number State | TN
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