# GREGORY WILKINSON SMITH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1891267647
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | C0007057 | MD | — |
| 363A00000X | Physician Assistant | C0007057 | MD | Yes |

## Other

- **Enumeration date:** 12/18/2018
- **Last updated:** 12/20/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | C0007057 | MEDICAL LICSENSE | MD |