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General NPI Number Information
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NPI Number | 1568480226
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Entity Type | Individual
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Provider Name | MARY F. DAILEY-SMITH M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 02/02/2016
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Provider Practice Location Address
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Address Line | 1008 N PIEDMONT AVE
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City | ROCKMART
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State | GA
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Zip | 30153-2526
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Country | US
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Telephone | 770-684-6100
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Fax | 770-684-8294
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Provider Business Mailing Address
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Address Line | 5610 WENDY BAGWELL PKWY SUITE 103
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City | HIRAM
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State | GA
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Zip | 30141
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Country | US
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Telephone | 770-943-7808
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Fax | 770-943-7805
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 050472
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License Number State | GA
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