Individual
HUBERT RANDOLPH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
658 NORTHSIDE DR E, SUITE A, STATESBORO, GA 30458-4828
(912) 764-9684
(912) 489-8676
Mailing address
658 NORTHSIDE DR E, SUITE A, STATESBORO, GA 30458-4828
(912) 764-9684
(912) 489-8676
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18745
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000132547I
—
GA
Enumeration date
05/23/2005
Last updated
09/17/2020
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