Individual
DR. ROBERT LYNWOOD SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 DOCTOR'S DRIVE, SUITE 201, DOUGLAS, GA 31533-2210
(912) 383-7976
(912) 383-7974
Mailing address
1100 WARD STREET EXT W, DOUGLAS, GA 31533-1902
(912) 384-1477
(912) 384-1470
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
31837
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031837
PHYSICIAN LICENSE
GA
01
—
11D1089117
CLIA ID - 100 DOCTORS DR STE 201
GA
01
—
11D1105865
CLIA ID - 17 JOHNSON ST
GA
01
—
341265
WELLCARE
GA
05
—
455142019C
—
GA
05
—
455142019D
—
GA
01
—
DH1281
MEDICARE RAILROAD - GROUP #
GA
01
—
GRP7930
CAHABA MEDICARE GROUP #
GA
01
—
P00726007
MEDICARE RAILROAD - PTAN
GA
Enumeration date
08/23/2005
Last updated
03/07/2023
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