Individual
DR. JASON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
550 PROFESSIONAL DR, MACON, GA 31201-1441
(478) 741-3007
(478) 742-8837
Mailing address
550 PROFESSIONAL DR, MACON, GA 31201-1441
(478) 741-3007
(478) 742-8837
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
052635
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
813202619A
—
GA
Enumeration date
10/23/2006
Last updated
03/10/2011
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