=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689664393
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES STEWART SMELTZER MD, FACOG, SMFM
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/25/2005
-----------------------------------------------------
Last Update Date | 03/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 833 CAMPBELL HILL ST NW STE 400 WELLSTAR NW WOMEN'S CARE
-----------------------------------------------------
City | MARIETTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30060-1147
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-528-0260
-----------------------------------------------------
Fax | 770-528-0269
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 833 CAMPBELL HILL ST NW STE 400 WELLSTAR NW WOMEN'S CARE
-----------------------------------------------------
City | MARIETTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30060-1147
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-528-0260
-----------------------------------------------------
Fax | 770-528-0269
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 041365
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207VM0101X
-----------------------------------------------------
Taxonomy Name | Maternal & Fetal Medicine Physician
-----------------------------------------------------
License Number | 041365
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 2085B0100X
-----------------------------------------------------
Taxonomy Name | Body Imaging Physician
-----------------------------------------------------
License Number | 041365
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 207VC0200X
-----------------------------------------------------
Taxonomy Name | Critical Care Medicine (Obstetrics & Gynecology) Physician
-----------------------------------------------------
License Number | 041365
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------