Individual
JASON L SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M D
Contact information
Practice address
103 JOHN MADDOX DR NW, ROME, GA 30165-1419
(706) 235-7711
(706) 235-9944
Mailing address
103 JOHN MADDOX DR NW, ROME, GA 30165-1419
(706) 235-7711
(706) 235-9944
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
032302
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000398384B
—
GA
Enumeration date
07/25/2006
Last updated
02/16/2010
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