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Individual

DR. SHANNON JANINE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2701 N DECATUR RD, DECATUR, GA 30033-5918
(877) 749-7428
(512) 628-3314
Mailing address
1776 WOODSTEAD CT STE 208, THE WOODLANDS, TX 77380-1480
(877) 749-7428
(512) 628-3314

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
66325
GA
2081P0301X
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
66325
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003128924G
GA
Enumeration date
09/17/2007
Last updated
11/21/2025
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