Organization
FAMILY PRACTICE CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHEILA JEANNE SMITH DO (OWNER)
(770) 963-0927
Entity
Organization
Contact information
Practice address
696 GRAYSON HWY, LAWRENCEVILLE, GA 30046-6372
(770) 963-0927
(770) 963-9772
Mailing address
696 GRAYSON HWY, LAWRENCEVILLE, GA 30046-6372
(770) 963-0927
(770) 963-9772
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20001
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000302222A
—
GA
05
—
00168869A
—
GA
Enumeration date
10/02/2007
Last updated
12/02/2010
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