Individual
DANIEL J SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
747 S HILL ST, GRIFFIN, GA 30224-4830
(770) 228-5407
(770) 227-1430
Mailing address
592 WATSON RD, FORSYTH, GA 31029-3503
(770) 714-6056
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
RN113417
GA
363LF0000X
Family Nurse Practitioner
Primary
RN113417
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00077466G
—
GA
05
—
000777466F
—
GA
01
—
P00426911
RAILROAD MEDICARE
—
01
—
P00428789
RAILROAD MEDICARE
GA
Enumeration date
03/20/2006
Last updated
07/18/2012
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