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Individual

GARY LAURENCE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1230 JOHNSON FERRY RD, SUITE H-30, MARIETTA, GA 60068
(770) 565-4224
(770) 509-0487
Mailing address
1230 JOHNSON FERRY RD, SUITE H-30, MARIETTA, GA 60068
(770) 565-4224
(770) 509-0487

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
015509
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000182069C
GA
Enumeration date
11/22/2006
Last updated
07/02/2013
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