Individual
JENNIFER J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2001 PEACHTREE RD NE STE 645, ATLANTA, GA 30309-1476
(404) 605-2050
Mailing address
2727 PACES FERRY RD SE STE 1-1100, ATLANTA, GA 30339-6151
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
2003
CO
363AS0400X
Surgical Physician Assistant
Primary
9313
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016035
KAISER COMMERCIAL NUMBER
CO
05
—
51782863
—
CO
Enumeration date
03/07/2007
Last updated
10/28/2019
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