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NPI Code Detail

MEDICARE: DR. GREGORY SCOTT SMITH MEDICAL DOCTOR

MEDICARE:  DR. GREGORY SCOTT SMITH  MEDICAL DOCTOR
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
1207RG0100XGastroenterology Physician047532GA
2207R00000XInternal Medicine Physician047532GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1047532OTHERGASTATE LICENSE NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992807242
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY SCOTT SMITH MEDICAL DOCTOR
Provider Business Mailing Address
First Line : 21 JEFFERSON PL STE 1
Second Line : SUITE 1
City : ATHENS
State : GA
Zip : 30601-1761
Country : US
Telephone Number : 706-548-0058
Fax Number : 706-548-0555
Provider Business Practice Location Address
First Line : 21 JEFFERSON PL
Second Line : SUITE 1
City : ATHENS
State : GA
Zip : 30601-1761
Country : US
Telephone Number : 706-548-0058
Fax Number : 706-548-0555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2006
Last Update Date : 02/06/2026

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Directions to “ DR. GREGORY SCOTT SMITH MEDICAL DOCTOR” Practice Location

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