Individual
FREDERICK SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(706) 323-0174
(706) 256-3264
Mailing address
86 LEE ROAD 450, PHENIX CITY, AL 36870-8064
(706) 527-2131
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
11/29/2011
Last updated
11/29/2011
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