Individual
DR. RYAN THOMAS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1330 INTERSTATE PKWY, AUGUSTA, GA 30909-5625
(706) 651-2020
(706) 855-6674
Mailing address
1330 INTERSTATE PKWY, AUGUSTA, GA 30909-5625
(706) 651-2020
(706) 855-6674
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
57009416
OH
207W00000X
Ophthalmology Physician
Primary
66645
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202I183712
PTAN
GA
05
—
2965260
—
OH
01
—
P00725745
RAILROAD MEDICARE
KY
01
—
P00748929
RAILROAD MEDICARE
OH
Enumeration date
05/31/2007
Last updated
05/28/2015
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