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Individual

DAPHENE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
101 REGENCY PARK DR STE 110, MCDONOUGH, GA 30253-7076
(404) 996-0126
Mailing address
1825 HIGHWAY 34 E STE 1200, NEWNAN, GA 30265-6416

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
085-002952
IL
207P00000X
Emergency Medicine Physician
2008018559
MO
363A00000X
Physician Assistant
Primary
009234
GA
363A00000X
Physician Assistant
085002952
IL
363AS0400X
Surgical Physician Assistant
085002952
IL

Other

Enumeration date
08/18/2006
Last updated
08/09/2023
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