Individual
JUSTIN R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
605 S ENOTA DR NE, GAINESVILLE, GA 30501-2437
(770) 538-0208
(770) 538-0556
Mailing address
605 S ENOTA DR NE, GAINESVILLE, GA 30501-2437
(770) 538-0208
(770) 538-0556
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
005694
GA
Other
Enumeration date
10/19/2009
Last updated
06/20/2011
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