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Individual

ALLAN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
3100 KEMBLE AVE, BRUNSWICK, GA 31520-4211
(334) 279-1450
Mailing address
PO BOX 235019, MONTGOMERY, AL 36123-5019
(334) 279-1450

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3942
SC
367500000X
Certified Registered Nurse Anesthetist
RN066827
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
AN1996
SC
Enumeration date
08/23/2007
Last updated
09/30/2009
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