Individual
DR. LUCAS GRADY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912
(770) 855-8747
Mailing address
1399 WALTON WAY APT 225, AUGUSTA, GA 30901
(770) 855-8747
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15149
GA
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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