Individual
MR. KENNETH L. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1120 15TH ST, NEPHROLOGY DIVISION, MEDICAL COLLEGE OF GA, BA-9413, AUGUSTA, GA 30912-0004
(706) 721-2861
Mailing address
4208 FAIRFIELD CIR, EVANS, GA 30809-3628
(706) 650-9552
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000725
GA
Other
Enumeration date
07/06/2007
Last updated
07/08/2007
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