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NPI Code Detail

MEDICARE: DR. RYAN THOMAS SMITH MD

MEDICARE: DR. RYAN THOMAS SMITH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician57009416OH
2207W00000XOphthalmology Physician66645GA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00725745OTHERKYRAILROAD MEDICARE
2P00748929OTHEROHRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3202I183712OTHERGAPTAN
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003017468
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RYAN THOMAS SMITH MD
Provider Business Mailing Address
First Line : 1330 INTERSTATE PKWY
Second Line :
City : AUGUSTA
State : GA
Zip : 30909-5625
Country : US
Telephone Number : 706-651-2020
Fax Number : 706-855-6674
Provider Business Practice Location Address
First Line : 1330 INTERSTATE PKWY
Second Line :
City : AUGUSTA
State : GA
Zip : 30909-5625
Country : US
Telephone Number : 706-651-2020
Fax Number : 706-855-6674
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2007
Last Update Date : 05/28/2015

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Directions to “ DR. RYAN THOMAS SMITH MD” Practice Location

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