Individual
KEVIN DESHAUN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3950 AUSTELL RD, AUSTELL, GA 30106
(770) 732-4022
Mailing address
3950 AUSTELL RD, AUSTELL, GA 30106-1121
(770) 732-4022
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
83486
GA
208M00000X
Hospitalist Physician
Primary
83486
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2015
Last updated
10/15/2019
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