Individual
RYAN BOUGHTON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-7025
(645) 607-3888
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34666
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
346664
—
SC
01
—
SC35428510
MEDICARE PIN
SC
01
—
SC35429068
MEDICARE PIN
SC
Enumeration date
06/29/2012
Last updated
06/15/2023
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