Individual
DR. MALLORY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 MEMORIAL DR, REIDSVILLE, GA 30453-4641
(912) 557-3434
Mailing address
210 E DERENNE AVE, SAVANNAH, GA 31405-6736
(912) 644-5300
(912) 644-5260
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
022471
GA
207Q00000X
Family Medicine Physician
Primary
022471
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000251842G
—
GA
Enumeration date
06/15/2006
Last updated
08/13/2013
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