MEDICARE: JAMES F. SMITH AND ASSOCIATES

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	103TC0700X	Clinical Psychologist	271	GA

General Provider Information

NPI Number	:	1679886972
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES F. SMITH AND ASSOCIATES

Provider Business Mailing Address
First Line	:	4651 ROSWELL RD
Second Line	:	SUITE B102
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30342-3048
Country	:	US
Telephone Number	:	404-256-6408
Fax Number	:	404-256-6408

Provider Business Practice Location Address
First Line	:	4651 ROSWELL RD
Second Line	:	SUITE B102
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30342-3048
Country	:	US
Telephone Number	:	404-256-6408
Fax Number	:	404-256-6408

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAMES FRANKLIN SMITH
Credential	:	PH.D.
Telephone Number	:	404-256-6408

Provider Enumeration Date	:	07/15/2010
Last Update Date	:	07/15/2010

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