Individual
DR. MARTHA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 HARRIS INDUSTRIAL BLVD STE A, VIDALIA, GA 30474-8852
(912) 535-3500
(912) 535-4498
Mailing address
PO BOX 407, VIDALIA, GA 30475-0407
(912) 537-4986
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
38614
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000607549N
—
GA
Enumeration date
08/03/2006
Last updated
04/28/2021
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