Individual
TIA SMITH NEELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1935 HOMER RD STE A, COMMERCE, GA 30529-8802
(706) 335-9060
Mailing address
PO BOX 117264, ATLANTA, GA 30368-7264
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
051379
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
862125982A
—
GA
Enumeration date
11/27/2006
Last updated
10/14/2021
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