Individual
MR. JAMES KELLY SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
710 CENTER ST, COLUMBUS, GA 31901-1527
(706) 571-1374
(706) 660-2686
Mailing address
PO BOX 2292, COLUMBUS, GA 31902-2292
(706) 571-1374
(706) 660-2686
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
001807
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001807
LICENSE
GA
Enumeration date
09/17/2009
Last updated
09/18/2009
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