Individual
DR. DONALD LANCE SMALLWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0001
(706) 721-8623
(706) 721-1459
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-8623
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
91813
GA
2085R0202X
Diagnostic Radiology Physician
RTL21-0032
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
91813
GA MEDICAL LICENSE
GA
Enumeration date
06/03/2016
Last updated
05/06/2022
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