MEDICARE: CRAIG E. SMITH, MD, PC

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
1	207RI0200X	Infectious Disease Physician	028464	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	F54518	OTHER		UPIN #
2	1285606012	OTHER		INDIVIDUAL NPI #
3	028464	OTHER	GA	GEORGIA MEDICAL LICENSE

General Provider Information

NPI Number	:	1538354980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRAIG E. SMITH, MD, PC

Provider Business Mailing Address
First Line	:	1909 ABERDEEN RD
Second Line	:	SUITE 105
City	:	ALBANY
State	:	GA
Zip	:	31701-1393
Country	:	US
Telephone Number	:	229-436-1361
Fax Number	:	229-436-3034

Provider Business Practice Location Address
First Line	:	1909 ABERDEEN RD
Second Line	:	SUITE 105
City	:	ALBANY
State	:	GA
Zip	:	31701-1393
Country	:	US
Telephone Number	:	229-436-1361
Fax Number	:	229-436-3034

Authorized Official
Title or Position	:	OWNER / PRESIDENT
Name	:	DR. CRAIG E. SMITH
Credential	:	MD
Telephone Number	:	229-436-1361

Provider Enumeration Date	:	09/10/2007
Last Update Date	:	03/07/2023

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