Organization
LANIER DERMATOLOGY & SKIN CANCER SPECIALISTS, PC
Active
Other names
Kevin L. Smith, MD PC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARMEN L SMITH (MANAGER)
(770) 538-0208
Entity
Organization
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
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005756529
AETNA
GA
05
—
000678983B
—
GA
01
—
0007735230
AETNA
GA
05
—
000814767A
—
GA
01
—
070011202
RAILROAD MEDICARE
GA
01
—
070015990
RAILROAD MEDICARE
GA
01
—
1306896931
BCBS
GA
01
—
1487604021
BCBS
GA
01
—
CH9982
RAILROAD MEDICARE
GA
Enumeration date
05/10/2006
Last updated
12/11/2015
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